Dáil Éireann debate -
Tuesday, 24 Apr 2018

Vol. 967 No. 7

Topical Issue Debate

General Practitioner Services Provision

Deputy Barry Cowen

I wish to raise the issue of the recent closure of Midoc out-of-hours GP service facilities in Birr and Edenderry, which were closed earlier this month. I disagree with the substance of that decision and indeed the manner in which it was carried out. When the HSE informed the public it was abrupt, uncaring and showed a huge disregard for the local communities where these facilities were placed.

Since then, we have heard the HSE apologise for the communication of the decision but defend its substance, citing a review commissioned by the Midoc services into issues surrounding security, clinical expertise and the one-person staffing of these facilities. The Minister for Health, Deputy Harris, in response to a parliamentary question I put down last week, also supported the recommendations and ultimately the decision of the HSE based on that so-called independent review.

I think it is only right that we put this local decision in a national context. Two years ago, in the programme for Government the Minister of State at the Department of Health, Deputy Finian McGrath, and his colleagues pledged a decisive shift in health services towards primary care, with the delivery of enhanced primary care facilities in every community. As part of this, they said "we will focus on developing an enhanced primary care system, and guaranteeing the future sustainability of GP practices in rural Ireland." The programme for Government went on to say, "We will reduce emergency department overcrowding following a four pronged approach", one aspect of which was "to reduce numbers coming into hospital by developing primary care services and integrating primary and secondary care services".

On top of this is the Sláintecare report, which the Minister of State and the Government support. This report also endorses the shift to primary care. The health service capacity review, published by the Minister earlier this year, projected that over the next 15 years there would be a 46% increase in primary care services. It could not be more clear to the Minister of State and his colleagues in government that we need more primary care services. Yet in Offaly, people are seeing the scope of primary care reduced with these closures in Birr and Edenderry.

An Leas-Cheann Comhairle

Go raibh maith agat.

Deputy Barry Cowen

I beg time on this, as two of us are sharing, if the Leas-Cheann Comhairle does not mind.

The review quoted by the HSE last week and the Minister's response to my parliamentary question were underhanded. The public had no say in this review. We do not support this review because we think it has no credibility. Therefore I have just three questions. Do the Minister of State and the Government agree that the failure to consult the local community to date is unacceptable? Do they accept the need for a new, inclusive, independent review? Do the Minister of State and the Government agree that this decision flies in the face of their own Government policy?

Deputy Carol Nolan

Like Deputy Cowen I am absolutely outraged and appalled by the decision to close Midoc services in Edenderry and Birr without any consultation or communication with public representatives or the general public. It is outrageous. We will not accept it. We are asking for solutions to be put forward and for our services to be reinstated, because we will not tolerate or accept this ridiculous decision, which puts patient safety at risk. It was unacceptable for public representatives to learn of these closures from constituents who were unable to access the services a few short weeks ago. People in Edenderry, Birr and north Tipperary depend on the vital basic services that Midoc offers in these towns. As I say, we will not be tolerating or accepting these closures, so what we want is a move towards reinstating and developing our health services to satisfaction in Offaly. Like many rural counties we are being left behind and we need our primary care facilities developed.

The closure of these services was met with great anger and frustration at a recent public meeting held in Birr and attended by hundreds of constituents. Neither the HSE or Midoc representatives attended this particular meeting. This was another insult to the general public and to the public representatives. The Minister for Health, Deputy Simon Harris, and the Minister of State have a responsibility here. I am calling for the Minister of State to intervene immediately to ensure that these services are not removed, but improved.

As a TD for Offaly I will be pursuing this issue, seeking for the services to be reinstated and nothing less than that. I outlined this position at a meeting with the HSE representatives and other public representatives from the county only last Tuesday. It was disappointing that this meeting had to be adjourned due to the absence of Midoc representatives. We were informed at this meeting that a risk assessment had been carried out by GPs who had concerns about the practice of one GP working alone in the centres. While we all agree that GPs should have a safe working environment, who is responsible for a risk assessment for our constituents as patients? They run a risk too if this goes ahead. Patient safety should always be of paramount importance and the closures will have a very serious impact on their safety.

We are all aware of the GP shortage. What plans does the Government have to address this issue? What plans does the Minister of State have to develop primary care centres in Offaly? I call on him to put forward solutions to address this shortage, instead of allowing Midoc to close vital and basic out-of-hours services in our towns. As the decision to close the services was not based on an independent review, but a review commissioned by the GPs, I am calling for the reinstatement of services. It was not done properly.

An Leas-Cheann Comhairle

I note that two wrongs do not make a right.

Deputy Carol Nolan

Tá brón orm. Bhí orm é sin a rá.

Minister of State at the Department of Health (Deputy Finian McGrath)

I thank Deputies Barry Cowen and Carol Nolan for raising this very important issue. I want to begin by reassuring the Deputies that there has been no reduction in funding or total GP clinical time allocated to the Midoc services. Second, I understand the decision to reorganise Midoc services in Offaly was taken by participating GPs in conjunction with the HSE and that they believe the revised arrangements will ensure a better out-of-hours services can be delivered to patients, with increased availability for call-outs and home visits to patients where clinically indicated.

The Midoc service was established in the west Offaly region in December 2002 by the HSE and the GPs who volunteered to provide the service. A review of Midoc services in Offaly was undertaken by the participating GPs in 2017. The review identified a number of concerns regarding the satellite sites in Edenderry and Birr, concerning clinical risks, the ability to respond effectively to medical emergencies and risks faced by locum doctors working alone. It is important to note that only limited out-of-hours cover was provided in Birr and Edenderry. The service was part-time only and home visits from these sites were not possible. On some days the service was only open for two hours and on other days no service was provided at all. For presentations outside the limited operating hours of both satellite centres, patients already had to attend the nearest full-time treatment centre, which would have been in Tullamore, Athlone or Longford.

In light of these concerns, and to ensure the quality and safety of patient services, the decision was taken that from 2 April 2018 Midoc would operate only one fully-functioning treatment centre in Tullamore that covers the entire Offaly population. This is in line with other Midoc centres across the midlands. The HSE has reviewed the current monthly activity levels of the out-of-hours services in Offaly and I understand the Tullamore treatment centre will be more than capable of absorbing patients from Birr and Edenderry. An additional doctor has also been assigned duty in Tullamore during weekends and public holidays to facilitate the more effective management of emergency call-outs to the entire county, including Birr and Edenderry. Additional administrative support will also be provided to free up doctors' time, resulting in more patient contact and a more effective overall out-of-hours service. As the Deputies will be aware, local HSE management met with the public representatives from Birr and Edenderry on 17 April to discuss the reorganisation of Midoc services.

At this meeting, the Health Service Executive accepted the need for improved public communication around such service changes in future and this is undoubtedly the case. The HSE has requested a further meeting between public representatives and Midoc and the Deportment has asked the HSE to keep it updated on developments.

I again reassure the Deputies that there has been no reduction in funding or total general practice clinical time allocated to the Midoc service. The HSE and the general practitioners participating in Midoc remain committed to providing a safe and effective out-of-hours service to all patients in County Offaly.

Deputy Barry Cowen

I thank the Minister of State for his response. He sought to reassure the House that there had been no reduction in funding. I assure him that despite the commitment in the programme for Government, Midoc services and facilities in Birr and Edenderry have been closed - period. I assure him also that it is not acceptable to cite a report that contends the service could be closed because it is limited and operates part-time. I do not accept that the review is to be trusted or was inclusive. It is compromised and has no credibility in my eyes and the eyes of other public representatives in the county in which I reside and have the privilege to represent. It failed to adequately consult representatives of the community, nursing homes, pharmacies and groups advocating for patients. How can members of the public be expected to buy into or take ownership of the decision when their wisdom and rights were excluded from the process?

Does the Government believe the review, which was instigated by vested interests, is inclusive of the public and the communities served by the facilities in question? If not, will the Minister agree to establish a new independent commission that will reflect the views, aspirations and rights of taxpayers and ensure the service, which was established in 2002 to serve 50,000 people and enhanced in 2008 continues and its abolition by the Government, notwithstanding the meaningless commitments it gave in the programme for Government, does not proceed?

Deputy Carol Nolan

With respect, funding was not flagged as an issue. The Minister of State wishes to give himself a pat on the back for the great job he and the Government are doing, but he would be wrong to do so. We have been informed that two basic and vital services will be withdrawn from our towns. The Minister of State did not address that issue or the fact that the review to which he referred was not independent. Apart from general practitioners, no one was consulted and Midoc and the HSE learned of it at a later stage. The Minister of State did not address the crucial issues.

I found deeply worrying a statement made by the Minister in a reply to a parliamentary question that he is statute barred from engaging in the process initiated by the HSE to review the delivery of health services. He is the Minister for Health. As public representatives, we are the first line of communication between our constituents, as patients, and the Minister. All of us are committed to mechanisms to achieve the best clinical outcomes for every patient, wherever they are in the country but particularly the most vulnerable and isolated citizens. The Minister should note that these closures will not be accepted. He must find an immediate solution and establish an independent review.

Deputy Finian McGrath

I am standing in for the Minister and I will bring to his attention the concerns and views expressed by Deputies Nolan and Cowen.

On the public consultation, the decision to provide general practitioner out-of-hours cover for the population of County Offaly was taken by the general practitioners who participate in Midoc in conjunction with the Health Service Executive on foot of an independent review which identified specific concerns regarding locum doctors working alone at the Birr and Edenderry Midoc sites. Local HSE management met public representatives from Birr and Edenderry on 17 April to discuss the reorganisation of Midoc services.

Deputy Barry Cowen

It was not an inclusive process.

Deputy Finian McGrath

At that meeting, the HSE accepted the need for improved public communication. It followed up with a request for a further meeting between public representatives and Midoc. This request has been submitted to Midoc and is being considered. We are, therefore, moving on the issue.

Deputy Barry Cowen

The Minister of State has not answered my questions.

Deputy Finian McGrath

As of 1 March, there were 24 vacancies in the general medical services, GMS, scheme nationally. As there are almost 2,500 general practitioners contracted to provide services under the GMS scheme, this constitutes a relatively low vacancy rate of less than 1%. All vacancies are currently covered by locum general practitioners and a GP service continues to be provided in all the affected areas.

The HSE national primary care division has undertaken a national review of the current GP out-of-hours service and a final report is expected to be completed by the end of the second quarter of 2018. We are, therefore, listening to concerns.

Deputy Barry Cowen

In the meantime, the services will be closed.

Deputy Finian McGrath

The report will make recommendations on the future provision of out-of-hours general practitioner services. I will bring the concerns raised by the Deputies to the attention of the Minister.

Deputy Barry Cowen

I am disappointed the Minister of State did not answer my questions.

School Closures

Deputy Seán Haughey

St. Thomas's school in Clonshaugh, Dublin 17, provides junior and senior cycle education for boys from the travelling community. It has been in existence for more than 30 years and currently has 33 students enrolled. Significantly, two pupils will do the leaving certificate examinations this year, three pupils are in fifth year and five pupils who will do the junior certificate examinations in June intend to progress to the leaving certificate. The patron of the school is the Archdiocese of Dublin.

The problem is that the Department of Education and Skills abruptly informed the school in recent days that it must close at the end of the current academic year, that is, in slightly more than one month from now. This decision has shocked school management and staff and students and their parents. I am aware that there have been problems in the school and the Department has carried out a number of inspections over the years. Management and staff strongly believe the Department has consistently failed to engage with them to alleviate any ongoing concerns. For example, a request for an additional teacher to facilitate leaving certificate students was consistently stonewalled by the Department.

I am aware from my time in the Department that inclusion and integration are now key policies in respect of Traveller education. However, St. Thomas's school is unique and still has an important role to play in the context of overall policy objectives.

The trust of parents is important and the parents of the pupils of St. Thomas's school want to send their children to the school. They have a real concern that their children will not survive in a mainstream school. They will certainly not continue to do the leaving certificate examinations if the Department's decision is implemented. The Department should show flexibility in its efforts to achieve overall integration. A leaving certificate qualification is a passport to a better life. While Youthreach is an option, if the students of St. Thomas's school wish to progress to the leaving certificate using the current model, they should be encouraged to do so. They will not enrol in a mainstream school. They are vulnerable and need more time to make the adjustment. I fear most of them will drop out of the system.

I know from first-hand experience the difficulties Travellers face in a mainstream school. I am worried about the effect the Department's sudden decision will have on students who will sit State examinations in June. It is disruptive and unsettling for them and all the other students in the school.

I visited St. Thomas's school last Friday where I met the principal, teachers, parents and pupils. As it happens, some of the students were doing practical examinations as part of the junior certificate home economics examination. I was very impressed with what I saw. Serious concerns were expressed and teachers and special needs assistants are also worried about their future. This issue that will have to be worked out separately.

I was surprised to learn that no formal face-to-face meetings had taken place between representatives of the school and departmental officials to work through problems. St. Thomas's school was given short notice to close its doors. As it is located in the Minister's constituency, I ask him at least to arrange a meeting between the school authorities and departmental officials to discuss these matters.

It is the Minister's constituency. Will he, at the very least, set up a meeting between the school authorities and departmental officials to discuss these matters? If the Department is determined to close the school, can it work out a plan to phase out the school over a number of years so all concerned have plenty of time to put in place alternative arrangements?

Minister for Education and Skills (Deputy Richard Bruton)

I thank the Deputy for raising this issue. I understand his concern. For a long time now, since 2006 in fact, the approach to education for Travellers has involved an integrated model. The Department has been moving to wind back the segregated model which was in place and I understand this is the only remaining school operating on this basis. There has been a consistent effort by the Department, working with the patron, to move to an integrated model. The Deputy referred to assessments and engagements with the school where defects had been identified. It is the Department's belief that the best future for these children is in another setting where they will do better, have a wider range of choice, get more support and be able to achieve more. The approach of an integrated setting is strongly favoured and has been a consistent one on the part of the Department. As to ensuring no child falls out of the system as a result of this proposal, I have insisted and the Department is determined to track each of these children to ensure each child gets a suitable placement. We are determined to see that.

I take the Deputy's point about giving this more time and winding the school down over some period, but a great deal of work has been done to adopt a different approach. It has not been successful to date and the Department is of the view that continuing on with this process is not in the best interests of the young people concerned. We have been successful in integrating young students in the system and there is growing rather than diminishing participation. The belief is that this decision is the correct one. Wider initiatives are being undertaken to ensure there is an enhanced uptake by Traveller children in education. The Department acknowledges the weaknesses there. As part of an integrated approach, led by the Department of Justice and Equality, in which we are participating, there are specific educational initiatives to be undertaken, including in our own area, to enhance the participation of Traveller children. That is being done with the support of the Traveller community itself. We have a better model in place and we are seeking to enhance it. That is the backdrop to this decision.

Obviously, it is the patron not the Department that closes a school. It is the patron which makes the decision on a matter like this. However, the Department has been working to see a better outcome and to move to a setting in which there is a wider range of subject choices and more supports. That is the direction in which this is going. I am acutely aware of the concerns raised by the Deputy. Equally, I am determined that no child is displaced by this. It is very important to work with Tusla and the patron through my Department and other schools to ensure these young men are supported in their continuing education.

Deputy Seán Haughey

I am aware of the integrated model. As the Minister knows, I was a Minister of State in the Department of Education and Skills with special responsibility for educational disadvantage as well as further education and training. Decisions were made at that time on senior Traveller training centres and so on. This school is a special one. It has a very special model in its own right. When I met some of the parents last Friday, their attitude was "Here we go again". They see Travellers at the bottom of the pile with the school being closed in one month and their children, quite simply, being discriminated against again by officialdom. I am also aware that the Minister has met at least one of the teachers in his advice clinic. He might like to deal with that. The teachers are obviously very concerned about the students, first and foremost, but they are also concerned about their own positions and those of the SNAs there. A great deal of work has to be done. To give one month's notice of the closure of the school is too short. It has come as a shock. The teachers and the parents are adamant that pupils simply will not go on to sit the leaving certificate examinations if they have now to enrol in a mainstream school. They will leave. I acknowledge the Minister's assurance that he will track each of the children, but looking at the local secondary schools, including Coláiste Dhúlaigh, which springs to mind, my experience suggests it is very difficult for Travellers to continue on to the leaving certificate. That is the objective. For all of those reasons, the Minister needs to give the school more time to put tracking measures in place, find suitable places and provide for supports. What I have heard is that these children were encouraged up to this point, but they now feel totally let down by the system once again.

Deputy Richard Bruton

I will ensure that there is very close liaison with the students to ensure there is an outcome for them. If I get the advice that we can do better for these young people and that prolonging this is not in their best interests, I have to take it seriously. Ultimately, it is the patron that decides whether to close but the policy of moving to a better model has been in place for a long time. The Deputy was in the Department himself in the period. This school is one which has remained in place and defects have been identified. There is no prospect of easily resolving those defects in the current setting. If we can get a new setting, that is the best outcome for the students involved. That is what I have been advised. I am trying to ensure the best outcome for students is achieved. I do not believe, on the basis of the advice I have received, that what the Deputy suggests would achieve that. I share his determination that the interests of the students should be to the fore. We need to work with them to ensure they get suitable placements and can fulfil their potential. I take the Deputy's points and will engage with my officials to ensure we do the very best we can to get a good outcome. I will report back to the Deputy to let him know how we are getting on with successful placement, which I hope we can achieve for the students involved.

Capitation Grants

Deputy Róisín Shortall

I thank the Minister for coming to the House to take this issue. Yesterday, the Catholic Primary School Management Association, or CPSMA, released a study on foot of its commission to Grant Thornton to carry out an analysis of the funding situation in most of our primary schools. The analysis highlights the major problems which have been caused to schools as a result of cuts in capitation and their accumulated impact since 2010. The capitation rate was cut from €200 per pupil to €170 per pupil in 2010 and, unfortunately, no progress has been made to reverse that. The report lays out in very stark terms the impact of the cuts and the fact that so many of our primary schools are struggling to meet their basic overheads and pay for heat, light, insurance and so on.

These are basic overheads which are not fully funded by the State.

The reduction in the capitation grant has varied to some extent between schools, depending on the size of the schools. In small schools, the capitation grant is worth about €26,000, or 42% of their day-to-day spending. In a medium school, the average capitation grant is €57,000 which meets just over half of its spending. In a larger school, the average capitation grant is €114,000 which represents about 61% of spending. The level of State funding for those basic items in schools falls far short of what is required to provide for a basic environment and conditions for students in order for them to function properly.

We hear all the time how the economy has turned the corner and there has been impressive growth in the past several years. We are told how matters are back on track while many of the cuts to pay and other funding have been reversed. There has been an element of tax cuts and the Government frequently talks about how it hopes to introduce further tax cuts. It is the height of folly in my view and highly irresponsible, however, to talk about the prospect of tax cuts when our primary schools do not have a basic level of funding that allows them to operate satisfactorily and in some kind of manner which one would have a right to expect in the present day and age.

Over recent years, children have disproportionately carried the burden of the recession. This is definitely borne out in respect of our primary schools. The conditions and the climate in primary schools are completely inadequate in terms of providing the right kind of atmosphere for children to learn well. Requests for voluntary contributions put significant pressures on children themselves and on their parents, while the shortfall in funding puts enormous pressure on schools. Increasingly, principals and teachers have to engage in basic fundraising to cover overheads. This is a diversion of attention from educational welfare and concerns to matters such as organising draws and sales of work. In this day and age, it is time to end that. Will the Minister give a commitment to reverse those cuts as a matter of urgency?

Deputy Richard Bruton

I thank Deputy Shortall for raising this issue.

As part of the programme for Government, we intend to increase capitation grants. In the past two budgets, I have secured €1 billion extra for education, of which 85% has gone into our schools. I have not been able to increase capitation grants but I have restored other important services needed in our schools. I have been in a position to fund more than 6,000 additional teachers and 3,000 additional special needs assistants, SNAs. Many of those teachers have gone to badly needed work. We have reformed the resource teaching model, which included putting 1,600 additional teachers over two years into resource teaching to strengthen the special education model. That was backed by an additional 3,000 SNAs. We have also, for example, opened more than 300 special units for children with special needs, which provide a high level of pupil support. We made investment in pupil places, which has to match the additional enrolment being experienced. We have continued to fund the reduction of the pupil-teacher ratio at primary level.

While I agree we need to examine the capitation grant issue, under the programme for Government we intend to increase it. Each year, however, we have to assess what other priorities need to be addressed. Significant funds of up to €1 billion have been provided, 85% of which has gone into schools. This has been an important investment and has allowed us to enhance many services both at primary and second level. It has allowed us to start investment in digital capacity, which is important to the quality of education provided.

I looked at the study carried out by Grant Thornton and it will be an input into our consideration of budgetary matters in the year ahead. We have introduced other measures to support schools in the management of their financial resources. A schools procurement unit has been established, as has a financial service support unit, which work with schools. They have helped schools to better manage issues that had been putting pressure on them. Voluntary contributions, as the Deputy said, must be voluntary. They cannot be required of a pupil to participate in education. We are clear on that and have emphasised it to schools repeatedly.

There are many legitimate needs in and demands on the education system. As the Deputy rightly adverted to, new entrant teachers are setting out their needs. There is a need for new curricula, as well as investment in teachers and SNAs. I try to balance those each year within the available resources. I will continue to do that. I recognise this is an important area of need.

Deputy Róisín Shortall

That was a disappointing response. It is shameful that almost 100 years since the foundation of the State, we still do not have free primary education. How basic can one get? This is in spite of the fact that Article 42.4 of the Constitution commits that "the State shall provide for free primary education", yet we do not have that free primary education. The programme for Government committed to investing in annual increases in primary and secondary capitation rates and that the Government would set three-year rolling programmes for the funding of schools. None of that has been done. The Minister published the glossy Action Plan for Education earlier this year, at the start of which he set out "our aim is to make the Irish education and training service the best in Europe by 2026". Those words ring hollow when the Minister cannot even provide the basic funding for items such as heating, cleaning, lighting and insurance in our schools.

We need to get our priorities right. Does the Minister believe in the principle of free primary education? If so, why is he not delivering on it? He talks about other areas of funding. While this is all very welcome, those other areas of funding which have been increased do not pay the bills in primary schools. Will the Minister give a commitment that he will, at a minimum, reverse the 2010 cuts in this year's budget? Will he also look at the overall funding requirements for covering the basics and overheads? What is provided only meets about half of the cost of running schools. This should be the Minister's and the Government's number one priority. We need to stop talking about tax cuts and other such measures when our children are paying the cost of the recession. Will the Minister commit to reversing these cuts as a matter of urgency in this year's budget?

Deputy Richard Bruton

I strongly believe in equality of opportunity in our education system.

Deputy Róisín Shortall

Yet the Minister will not fund it.

Deputy Richard Bruton

I have made the decisions that I believe will best serve our students and our pupils. I have put 6,000 additional teachers and 3,000 additional SNAs into our schools.

Deputy Róisín Shortall

That still does not pay the bills.

Deputy Richard Bruton

I have extended the support for disadvantaged schools to 110 additional schools.

I have made sure that 50,000 young people with special education needs fulfil their potential.

Deputy Róisín Shortall

None of those things pays the bills.

Deputy Richard Bruton

I have expanded the number of special units catering for children with very acute special needs.

Deputy Róisín Shortall

None of those things pays the bills.

Acting Chairman (Deputy Aindrias Moynihan)

Please allow the Minister to answer.

Deputy Richard Bruton

I have been able to preside over a situation where the latest assessment of our education at primary level shows that our primary pupils at ten years of age are the best readers in Europe and the best at mathematics in Europe. We are delivering money into the education system and we are making a difference in students' lives. Of course we will look at the other legitimate demands for additional resources but I can stand over a record of which I can be proud-----

Deputy Róisín Shortall

It will not pay for heating or cleaning or basic overheads.

Deputy Richard Bruton

-----in which more children are fulfilling their potential, particularly at primary level. It is a mark of what we have been able to achieve as a result of the economic recovery that we are putting it back into our young people to give them a future.

Deputy Róisín Shortall

It is continuing to put them under pressure.

Naval Service Operations

Deputy Maureen O'Sullivan

Tá mé buíoch go bhfuil deis agam labhairt ar an ábhar seo anocht agus é a phlé. I have raised this issue several times. I want to acknowledge that the Taoiseach and the Minister of State, Deputy McEntee, raised this issue at the highest levels in Europe but the reality is that the EU policies are continuing, which lead to human rights abuse.

This is a time when it is difficult to find a language to adequately describe the horror of the situation in Libya. There are two aspects to it, namely, what is happening in the Mediterranean and what is happening in the Libyan detention centres, the so-called reception centres. These two aspects are related. It is no exaggeration to say that these centres are on a par with the concentration camps of the Second World War.

The information I put on the record today comes directly from a medic who has worked both on the Mediterranean and in these centres and who I had the honour to meet recently. The situation was described as the highest level of human suffering that this medic has encountered. The centres are places of severe overcrowding. There are hangar-like cells with up to 3,000 detainees in each unit. There is limited and interrupted access to water. Illnesses range from TB, scabies, diarrhoea to violence-related injuries. There is evidence of beatings, burnings, torture and rape. This is happening in front of the staff and is also being done by the staff. There is acute malnutrition. Food can be a bread roll with a plate of pasta being shared by five people. As female cells are being staffed by male guards, there are extreme levels of sexual violence, rape, enforced prostitution and girls being taken from the centres and sold into brothels. Many babies are being born but there is no antenatal care. Sometimes these babies are being born to girls who are mere children themselves. This is a money-making operation as detainees can be sold at any time. The guards decide who avails of triage services and are in charge of medical supplies for money. They also determine, for money, who can have access to the therapeutic food programmes. That is what faces those who are being rescued in the Mediterranean. This is what is happening there and being facilitated through Operation Sophia, in which Ireland participates.

I will now refer to the Libyan coastguards' so-called rescue operations. The coastguards are aggressive and brutal in their actions, and there are eyewitness accounts of their brutality. I was given one example where coastguards tried to capsize a boat. Another eyewitness told of everyone on a boat being beaten. Because of the behaviour of the Libyan coastguard it is now more dangerous for those trying to cross the Mediterranean. What role is Ireland and its Naval Service, through the EU, playing in the training of those coastguards?

I also have heard accounts of confrontations between the Libyan coastguards and humanitarian rescue boats. Today, it is reported that an Italian court refused to release a dedicated search and rescue boat from a German NGO that was doing genuine search and rescue in the Mediterranean. The boat had been seized and impounded by the Italian authorities in August 2017. There was an NGO boat, which performed a rescue 73 nautical miles from the Libyan coast, in international waters, but the Libyan coastguard demanded that the people be transferred, under threats of violence. That was resisted and the people were brought to a port of safety but the NGO boat and its crew were punished. The EU is criminalising humanitarian organisations which are doing search and rescue. That is creating a very dangerous precedent for the future of humanitarian operations in the Mediterranean. The EU policy is one of interception and containment. That allows the Libyan coastguard to "rescue" those in the Mediterranean and bring them to detention centres, both official and unofficial. In that rescue, families are also being separated. This is facilitated by Operation Sophia. What role has the Irish Naval Service there? How complicit is the Irish Naval Service in facilitating the Libyan coastguard in bringing people to those horrific centres? Must the Irish Naval Service stand by while that is happening? That would be completely at variance with our development aid policy.

Minister of State at the Department of Defence (Deputy Paul Kehoe)

I thank Deputy Maureen O'Sullivan for raising this important. An Irish Naval Service vessel first deployed in the Mediterranean in May 2015 in Operation Pontus, a humanitarian search and rescue mission undertaken as part of a bilateral arrangement with Italian authorities. In the three years since that first deployment, the Naval Service of the Irish Defence Forces has rescued more than 18,000 migrants.

In July 2017, I secured Government and Dáil approval for the deployment of a contingent of the Permanent Defence Force to serve as part of the EU naval operation against human smugglers and traffickers in the southern central Mediterranean, Operation Sophia. In the course of the subsequent deployment of LÉ Niamh from October to December 2017 as part of Operation Sophia, the crew took part in search and rescue operations rescuing 613 migrants and assisting with a further 107 migrant rescues.

It should be noted that migrants rescued by the Naval Service are brought to a safe port or transferred to another vessel to be taken to a safe port. In that regard, migrants rescued by Operation Sophia are brought to ports in Sicily. In addition, the Irish vessel also undertook activities in support of the core task of the mission including gathering information on oil smuggling; patrols focusing on countering illegal arms trafficking; operations to intercept smugglers; and monitoring the effectiveness of the Libyan Navy and coastguard activity.

Operation Sophia’s mission is to identify, capture and dispose of vessels and enabling assets used or suspected of being used by migrant smugglers or traffickers; to prevent further loss of life at sea and to reduce the suffering and exploitation of migrants by countering and challenging the criminal organisations engaged in such activities. Operation Sophia is one element of a comprehensive approach to addressing the migrant crisis. The mission is also providing capacity building and training to the Libyan Coastguard and Navy and contributing to the implementation of UN Security Council Resolution 2292. This imposes an arms embargo on Libya in an effort to prevent the flow of illicit arms and related materiel into that country.

In February 2018, the Government again approved the continued participation of the Naval Service in Operation Sophia. Two naval vessels will deploy this year for a period of approximately 30 weeks in total. LÉ Samuel Beckett departed the naval base on 15 April to participate in Operation Sophia.

Operation Sophia has been effective in discharging its mission, including to identify, capture and dispose of vessels and enabling assets used or suspected of being used by migrant smugglers or traffickers. The mission is providing training to the Libyan Navy and coastguard and its presence constitutes an internationally recognised deterrent. There has been a significant drop in the number of migrants being smuggled to Europe on the central Mediterranean route and the number of deaths reported at sea has decreased.

The training being provided to the Libyan Navy and coastguard aims to improve the security of Libyan territorial waters; to enhance law enforcement at sea; and to improve their ability to perform search and rescue activities at sea. I am deeply troubled by reports of the grave and ongoing abuses perpetrated against migrants and refugees in Libya, including in detention centres. The Tánaiste and his EU counterparts have discussed these concerns on a number of occasions at the EU Foreign Affairs Council, and the Taoiseach raised his concerns at the European Council in October last year. I join my Government colleagues in calling on the Libyan Government, and all parties, including those with de facto control of territory, to take steps to eliminate ill-treatment of migrants and to facilitate access to detention centres by UN agencies and other humanitarian organisations.

The EU provides training, including in international humanitarian law, human rights and gender issues, to Libyan authorities. The EU is also working with the African Union and the UN to save and protect the lives of migrants and refugees in Libya, accelerating assisted voluntary returns to countries of origin and the resettlement of those in need of international protection.

In conclusion, thanks to these efforts, the number of migrants in official detention centres has fallen from an estimated 20,000 in 2017 to 4,000 in March of this year. A functioning and stable government for all Libyans is crucial to addressing the many challenges the country faces. Ireland fully supports the efforts of the UN special representatives to facilitate a lasting political solution in Libya.

Deputy Maureen O'Sullivan

We know of the great work the Irish Naval Service did in those genuine search and rescue operations, the lives that it saved and the medical and humanitarian services it provided for those rescued. The fall in numbers is because of the EU policy of containment, which means people are being brought back to those centres in Libya. Ireland and the Irish Naval Service are now part of that and it is damaging the very fine and honourable reputation of our Navy. There was an EU delegation to Libya recently. I believe it was the Dutch foreign affairs Minister who, after she visited the detention centres, said they should be closed as soon as possible, but the EU is still standing by that whole situation.

There are accounts of stand-offs between non-governmental organisation, NGO, rescue boats and the Libyan Coast Guard. I know of one example where both spotted a boat in distress. People in distress on the boat were jumping into the water and trying to swim to the NGO boat, away from the coastguard. The Libyan Coast Guard became very aggressive and the NGO boat had to leave the area. To clarify again, is the Irish Naval Service helpless when looking at the Libyan Coast Guard's so-called rescues of people in the Mediterranean? Were there times when the Irish Naval Service stood by and supported the Libyan Coast Guard intercepting those vessels in order to bring those people back to Libya or will there be times when it will do so? Is the Irish Naval Service leaving boats to be rescued by the coastguard knowing what it is rescuing people to? Have any rescued people been transferred from ships involved in Operation Sophia, including Irish ships, back onto the boats of the Libyan Coast Guard? The Minister of State accepts the reality of what I have said is happening in those detention centres. If he does, then he is allowing our navy, which is made up of very honourable fine men and women who have to obey their orders, to allow the Libyan Coast Guard to bring people it has rescued back into detention centres with inhuman and subhuman conditions.

Deputy Paul Kehoe

First, if migrants are transferred from an Irish naval vessel to another vessel, they are then transferred to safety on the Italian coastline. To say they are brought back to Libya is totally untrue. That is not happening. Operation Sophia has been effective to date. The main focus of the mission is security and interception operations to disrupt the operations of criminal organisations engaged in human smuggling and trafficking, organisations which prey on vulnerable people and which are exacerbating the migrant crisis in the Mediterranean. The number of migrants coming through the central Mediterranean route has fallen and action against illegal arms trafficking is ongoing.

The recent statistics from the UN migration agency, the International Organization for Migration, indicate that 10,949 migrants and refugees have entered Europe by sea during the first nine weeks of 2018. This compares to 20,051 arrivals across the region during the same period in 2017. In 2016 the corresponding figure was almost 135,000. Up to 7 March this year there have been 442 reported migrant deaths in the Mediterranean compared to 521 in 2017. Thanks to all of the people involved and the efforts they are making the number of migrants in official detention centres has fallen from an estimated 20,000 people in October 2017 to 4,000 in March 2018. There has been a significant fall in the number of migrants in these detention centres.

This has been raised at the highest level. It has been raised by the Tánaiste and Minister for Foreign Affairs and Trade. It has been raised by the Taoiseach at EU Council level. I understand the Minister for State, Deputy Helen McEntee, has also raised this issue. I know that both she and the Taoiseach have raised that issue here in the Dáil and with their EU counterparts.