The Minister of State, Deputy Noonan, is branching into the health sphere in a big way today.
Saincheisteanna Tráthúla - Topical Issue Debate
Health Services Staff
I am versatile if nothing else.
This matter relates to the appointment of a consultant ophthalmology surgeon at South Infirmary-Victoria Hospital and the need for funding to be set aside to allow that appointment to proceed. This is extremely important. We have built a new outpatient ophthalmology unit in South Infirmary-Victoria Hospital. We have built two brand-new theatres that are fully equipped and ready to be open in mid-January. The problem is we were to transfer all the ophthalmology services from Cork University Hospital to South Infirmary-Victoria Hospital. It is not going to take place because the funding has not been allocated for the appointment of the consultant ophthalmology surgeon. There is a refusal by people to transfer until that position is clarified and the funding allocated. This is an extremely important appointment. It is an extremely important development in the context of ophthalmology services in the south and south west. If this funding is not made available, we will have further delays to the opening of a brand-new and completed facility with two new theatres and a new outpatients unit.
The submission for this appointment to be made was submitted over nine months ago. I understand it is a case of someone in the HSE signing off to confirm that funding will be made available and the position can then be advertised. As the Minister of State knows, once the position is advertised it takes a period for it to be filled, but I understand that people will transfer knowing full well that the funding is available and that the position will be filled in due course. The problem is that the HSE has not sanctioned the funding. Consequently, we have a brand-new facility that we cannot use. This matter needs to be dealt with immediately. I ask that the Minister for Health, Deputy Donnelly, instruct the HSE to sanction the funding in order that we can proceed with advertising the position and with opening this new facility for the south and south west.
Gabhaim buíochas leis an Teachta. I am taking this matter on behalf of the Minister for Health.
The demand for ophthalmic services has grown in the region in question over the past number of years. This is due both to the development of new treatments and the ageing population profile. Recent reports predict that this demand will continue to increase in the coming years. In line with recommendations in the National Clinical Programme for Ophthalmology: Model of Eye Care from 2017, and in Reconfiguration of Acute Hospital Services, Cork and Kerry - A roadmap to develop an integrated university hospital network, it was decided there should be a regional department of ophthalmology.
The South Infirmary Victoria University Hospital was chosen as the site best suited for this. As part of these developments, the ophthalmology outpatients department, OPD, and eye casualty at Cork University Hospital and the OPD from Mercy University Hospital will transfer to a new OPD and eye casualty building at SIVUH. These transfers are expected in early 2023.
The new ophthalmology unit includes two operating theatres, anaesthetic, scrub and prep rooms, a recovery unit and an ophthalmology day unit. The new unit will also include the most modern equipment and will have access to supportive diagnostic technology. In addition to developing hospital services, this new unit will also support continued work with the regional eye care service based in the primary community care centre in Ballingcollig. This will further strengthen links between the community and the acute hospital setting for the benefit of ophthalmology patients. It is the intention of the South/Southwest Hospital Group and the community health organisation to expand the capacity within ophthalmology services to meet the increased service demands, including the expansion of surgical and medical consultant ophthalmologist posts.
The HSE has advised that approval for an additional consultant ophthalmic surgeon post is being examined in the context of the funding available in 2023 in order to further expand the current service. The new ophthalmology unit provides further evidence of the Government's commitment to South Infirmary Victoria University Hospital and to the people of Cork in providing the most appropriate care in the right place at the right time. The new ophthalmology unit is an extremely significant milestone in the evolution of services, both acute and community, for the people of Cork and the South/Southwest Hospital Group. I am not sure if that actually responds to the specific question the Deputy asked but I might come back in.
I am just concerned about the use of the words "being examined". That is not going to sort my problem out. There is a new unit that has been physically built and is fully equipped, ready to roll, and there will be no use of that facility for at least three months now. We intended to open it in the middle of December. It will now not be opened because this post has not been sanctioned. My understanding is that this has been sitting on someone's desk for a long period of time now. I am asking the Minister for Health to instruct the HSE to make the funding available so the post can be advertised. I am disappointed with this reply. I understood that this was a case of someone signing off and then we could proceed to advertise the post. The Minister of State is now more or less saying that nothing is going to happen until some time in January, and probably the end of January, which means we will not be opening this new outpatient unit and these two new theatres until next July. This is not good enough. The funding has been made available by the Department and the HSE to do the building work. All of that is done. There were delays in certain aspects of those contracts. In fact, I had expected us to be opening the unit this time last year. We have delayed it 12 months and now we are going to have a delay of another six months. I am saying it is not good enough. We have to get the funding sanctioned and get that done before the end of this Dáil term. Otherwise, we are going to drag on for another six months with huge money being expended and the unit not being used. At the same time, there are people travelling to Northern Ireland in order to get ophthalmology treatment. It is not good enough. The reply is not acceptable. The wording "being examined" is not what I wanted to hear tonight.
I am afraid my closing response will not give the Deputy any additional assurance. I will certainly take his concerns back to the Minister for Health. The response states that an additional consultant ophthalmic surgeon post will be required to further expand the service and that approval for the post is being examined in the context of funding made available for the HSE in 2023. That is pretty vague. We will try to get a more specific response on that for the Deputy.
In fairness to Gerry O'Dwyer, who retired yesterday as the CEO of the South/Southwest Hospital Group, he wanted to sign off on this before he left. He tried everything to get it signed off but that has to be done at a national level. He has now retired and he is disappointed that this has not been signed off. I ask that I get a response to this within the next seven days.
I appreciate that. We will certainly get the Deputy a response on that. I have figures here that I will pass on to him about the waiting lists for ophthalmology services, some of which are positive. Waiting lists have decreased in some areas. I will take the Deputy's concerns back to the Minister directly and get a response for him.
Traveller Accommodation
I am glad the Minister of State is in the House to listen to this. What he has to try to get into his mind is what it would be like if tonight the people who are here had to sleep in a 20-year-old caravan or mobile home that is damp, in this kind of cold weather, and had to do this on a council halting site in this day and age. Quite rightly, we give out about the conditions for people looking for asylum and for students. Pettymindedness has done a great disservice to Travellers. When the Minister of State, Deputy Peter Burke, spoke to the Joint Committee on Key Issues affecting the Traveller Community, he told us the Department of Housing, Local Government and Heritage had "rolled out a six-month pilot preferential caravan loan scheme in four local authority areas." The scheme would allow participants to draw down up to €30,000. He said the Department hoped to roll out the scheme nationwide in 2022, following a review of the pilot. It did roll it out nationwide, following a case taken to the ombudsman by a woman in my constituency. What did the Department do? It made the scheme nationwide but it put a quota on the number of caravans or mobile homes. In a case in Galway, there were 24 applicants living in atrocious conditions and the Government decided to allocate four caravans. At a time when a decision was made last week - I am not against the decision - to spend hundreds of millions on student accommodation, could we not give each Traveller family that needs a new caravan the money to get it? This is a shame on our nation. I hope the Minister of State goes back to the Department and puts this right forthwith.
One of the recommendations of the Joint Committee on Key Issues affecting the Traveller Community was:
The audit [in recommendation No. 68] should include the mobile homes or caravans that are used as permanent dwellings. In the case of people/families wishing to remain living in caravans/mobile homes where they are deficient, they should be immediately replaced by new caravans/mobile through and expanded “loan scheme” or by direct supply by the relevant local authority. These should be funded out of the budget allocation for “traveller housing” and the quality of these caravans should be monitored in the short term by Cena to ensure they are of good quality. In the longer term this role should transfer to the National Traveller Accommodation Authority. The amount offered in the Caravan loan scheme should be monitored regularly to ensure that high-standard residential quality mobile homes can be afforded".
Deputy Ó Cuív made the point about what was said to the committee by the Minister of State. There was an expectation that after that pilot, which happened back in 2021, it would be reviewed in early 2022. We are still facing situations where Traveller families cannot access these more efficient mobile homes, which they need. This is how the State is treating the Travelling community. Travellers are only 1% of the population but they have the highest suicide rate, the highest number of people in homelessness and the lowest lifespan compared to the general population. We just keep treating them abysmally. There has to be some accountability about these recommendations, what has been promised to the Travelling community and what is not done. We have to set up a follow-on committee from the Joint Committee on Key Issues affecting the Traveller Community, in order to have oversight of what we recommended. That needs to be put in place. I know the Ceann Comhairle has not been well but we need to get that back up and running again because incidents like this have to stop.
I am familiar with the matter from many of my Traveller friends in my home town, whom I have seen in conditions that have been completely inadequate. I have also seen great strides being made. There is no doubt that Government is committed to ensuring that the actions the Deputies spoke about will be met in terms of resourcing. It is important, particularly in the depths of winter, that Traveller families are not living in substandard conditions. It is unacceptable.
The Housing (Traveller Accommodation) Act 1998 provides that local authorities have a statutory responsibility for the assessment of the accommodation needs of Travellers and the preparation, adoption and implementation of multi-annual Traveller accommodation programmes, TAPs, in their areas to meet the identified accommodation need. The role of the Department of Housing, Local Government and Heritage is to ensure that there are adequate structures and supports in place to assist the authorities in providing such accommodation, including a national framework of policy, legislation and funding.
The Department originally introduced a pilot preferential caravan loan scheme in a selected number of local authorities over a six-month period from July to December 2021, following consultation with local authorities and other stakeholders. The pilot scheme was introduced under section 25 of the Traveller Accommodation Act 1998 to support the provision of Traveller-specific accommodation. The purpose of the scheme was to enable local authorities to provide loans to Travellers to purchase their own caravans or mobile homes for use as their primary residence on a halting site at a preferential rate. Loans may be advanced to an applicant assessed by the local authority as being in need of accommodation either on the social housing waiting list or in need of an upgraded caravan or mobile home as their principal residence and not in a position to provide for same partially or fully from their own resources.
In this initial pilot, a small number of loans were drawn down and, consequently, the evidence base was insufficient to support an enduring scheme. The Department expanded the pilot nationwide, following approval from the Department of Public Expenditure and Reform. A circular was issued from the Department to all local authorities in July 2022 outlining details of the expanded pilot caravan loan scheme. As this is a pilot scheme, there is provision for up to 75 caravans or €3 million in expenditure, whichever is the lesser, nationwide until the end of 2022. The uptake so far has been positive, with strong demand across local authorities, which is probably reflective of increasing family numbers and sizes.
At the end of this expanded pilot, a review will be carried out by the Department with input from local authorities and other stakeholders and a report will be made to the Department of Public Expenditure and Reform. Options for an enduring scheme will then be considered at the conclusion of this process. Meeting the needs of all Traveller communities, as demonstrated by the pilot caravan loan scheme, continues to be a priority for local authorities and the Department and my colleagues, the Minister, Deputy Darragh O'Brien, and Minister of State, Deputy Peter Burke.
In the words of Greta Thunberg, this is just, "Blah, blah, blah". I represent Galway West and in Galway city alone, there is a need, so that people can go to bed and sleep in a comfortable caravan. There is a need for 24 caravans now. What are we getting? We are getting process after process. We are spending billions of euro in this State accommodating people, and rightly so, but when it comes to Travellers, we seem as a State to be small-minded and mean. Is the Minister of State saying that the State cannot afford a decent caravan to replace a 20-year-old caravan for people who have had them for 20 years and looked after them? Can we not afford that, particularly when they pay back the cost of the caravans in a weekly rent? I beg the Minister of State to go back to the Department and say, "Cut the petty-mindedness". There should be one for anybody who needs it now, on a needs basis. There should not another winter with people ringing me up in tears because of the conditions they are being asked to live in. The Ombudsman came out and saw one of these caravans but the lady concerned is not going to get one, even though he recommended it.
I agree entirely with Deputy Ó Cuiv. There seems to be a mealy-mouthed response across the board to the Travelling community. If a Travelling family goes to their local authority and says that it needs to change their caravan as it is 20 years old or whatever, they should be able to access the money to do it. It should not be a question of continuing to sleep in the cold. We have had a few nights of cold weather, but more is to come. Only a few weeks ago, three members of the Joint Committee on Key Issues affecting the Traveller Community had to bring forward a Topical Issue matter regarding Spring Lane in County Cork because of the lack of response from the local authority, Cork County Council, to the needs of the Travelling community in that halting site. Things that were supposed to have been done a year ago were not done even though the people were promised it. It was still going on, so we had to raise it again in the Dáil. There is a question mark over how the Department and how Government address the issues affecting the Travelling community. It is important that we follow-up on that report and ensure that it is followed through.
There is no issue with Government in terms of resourcing. The Minister of State, Deputy Peter Burke, was quite clear at the outset-----
Where is it then?
He was quite clear at the outset of his tenure to ensure that local authorities drew down all of their moneys for Traveller accommodation. The Deputy may recall, historically, there had been an underspend in many local authorities. All local authorities, under the Traveller accommodation programme, need to draw down their moneys and spend their allocations. Many Travellers, particularly younger Travellers, are moving into private accommodation and into different types of accommodation. That is also recognised. Specifically in relation to this, I will go back to the Minister and the Department about moving this scheme from a pilot to an enduring scheme. As both Deputies pointed out, there is a need for families to have an enduring scheme that would support them moving into the good-quality mobile homes they want to live in. I have been in many of them and they are comfortable and fantastic when families get them. It transforms quality of life for children in particular, as well as the whole family. We will go back to the Department and if there is an issue, which the Deputies are clearly saying there is, local authorities need to be proactive and the scheme needs to move from a pilot scheme to an enduring scheme. We should give consideration to that.
The Minister of State should be under no misunderstanding. The Department allocated the four caravans to Galway, not the local authority.
It is under the pilot scheme, I understand.
It was the Department that allocated the four caravans. The problem is the Department; that is why we are here today. The local authority and the Ombudsman will sort it.
I will relay that back to the Department.
Will the Minister of State provide the evidence about what was drawn down last year and the beginning of this year?
We can get those figures for the Deputies.
Heritage Projects
I know the Minister of State and others in the House have an interest in the architecture of Dublin, the country as a whole and our history. The Iveagh Markets on Francis Street is a building of major importance. It is a huge site in the Liberties. It was built at the turn of the 20th century as an indoor market. I think the Minister of State was down there recently. He will understand the need for the State to step in at this stage, given the state of dereliction and disrepair of this beauty of, one could say, an industrial site. It is also a site that one can easily see and imagine the splendour of when walking around it. It is also functional. We have seen footage of St. George's Market in Belfast and the English Market in Cork and any town in Europe that has retained its markets. Sometimes they are smaller but one can see how functional they can be, especially in an era when we are trying to be sustainable.
The site is in the heart of the city in an area which has increased in density because of building work over the years. Many apartments have been built and there are more people living in the area. It would be great to see a food market again in the heart of Dublin. There were food markets in Newmarket until recently but because of developments, they were moved out. They still exist and try to thrive. It would be great to see that again.
There has been a huge change in culture in regard to repurposing and reusing clothes. One of the last parts of the Iveagh Markets, the part that I remember, was second-hand clothes. I was in the building a number of months before the market closed and it was in rag order, as we say in Dublin. It was not in a fit state. That is one of the reasons the market closed. There were still businesses trading and there are still people who lovingly remember the trade, the banter and the bartering that went on with those old-style market stalls that were in the Iveagh Markets and elsewhere around the country. We have an opportunity not necessarily to bring the market right back to previous times but it is a space that could be used as such spaces are used in other areas. We could use it as a market stall in the mornings and weekends and for other purposes too. It can be cleaned out easily. It is a vast complex. If it is left to the vagaries of winter again, more damage will be done.
When the Iveagh Markets closed Dublin City Council estimated it would cost €1 million or €2 million to refurbish the building. Now it is talking about €20 million. That is the damage caused by years of neglect and awaiting development that never happened. Mediation is supposedly going on between those who claim ownership. At some stage, someone has to call a halt to that. The longer that mediation goes on, the more dangerous the building becomes and the more likely it is that someone will have to step in and take action. For this reason, I call on the Minister of State who has an interest in heritage in the city to step in. This would be a major attraction to add to all of the other buildings in the vicinity on the tourist trail but also for the community. The Minister of State helped out before in regard to St. Patrick’s Cathedral. Christ Church Cathedral is around the corner. Tailor’s Hall is An Taisce’s building and great work is planned for that. The Iveagh Markets are next door and could add to the tourist trail as well as the local community which recently lost two community halls in the vicinity.
There is no doubt that the Iveagh Markets are important architecturally but also socially for the community around the Liberties. It is an impressive building in its wider context on the street but also as a heritage building. There has been a great deal of concern expressed about it of late and down the years.
I will outline a couple of points. My functions as Minister of State with regard to the protection of our architectural heritage are set out in the Planning and Development Acts, as are the responsibilities of local authorities and owners. Part IV of the Planning and Development Act 2000, as amended, gives responsibility to planning authorities to identify and protect the architectural heritage by including particular structures on the record of protected structures, RPS, and overseeing development and safeguarding of the structures accordingly.
With regard to procedures for identifying architectural heritage, the National Inventory of Architectural Heritage, NIAH, was established by the Architectural Heritage (National Inventory) and Historic Monuments (Miscellaneous Provisions) Act 1999. Its purpose is to identify, record and evaluate the post-1700 architectural heritage of Ireland as an aid to its protection. As Minister of State, I can make recommendations to planning authorities for buildings and structures to be included on the RPS. In general, I make these recommendations on foot of the surveys carried out by the NIAH. However the final decision as to the inclusion of a building or structure on the RPS remains a reserved function of the relevant planning authority's elected members.
The Iveagh Markets building was recorded by the NIAH in November 2013 and rated as being of regional importance. As such, it was recommended to the local authority for inclusion on its RPS. I am informed that Dublin City Council has included the Iveagh Markets on its RPS, reference No. 2936. Inclusion on the RPS obliges owners and occupiers to prevent endangerment of the building and requires the local authority, where it has formed the view that the building is or will become endangered, to serve notice on the owner or occupier to carry out remedial works. Where the owner or occupier fails to carry out the works specified by the planning authority, the Act gives the planning authority a range of discretionary powers to safeguard the structure in question, including powers to enter a property, carry out works required to prevent endangerment and recover the associated costs from the owner or occupier.
As the Deputy will be aware, there is currently a dispute over the title to the Iveagh Markets between three separate parties. The matter has been before the High Court since 2021 and I understand that mediation was due to resume on 28 November. In these circumstances, it would not be appropriate for me to comment on the matter of ownership. Officials in my Department remain available to advise Dublin City Council on any future efforts to restore the building.
I draw the Deputy's attention to the financial support provided by my Department for the protection of heritage buildings and historic structures through the historic structures fund, HSF, and the built heritage investment scheme, BHIS, which are administered by local authorities. I recently announced funding of €9 million for both of these schemes in 2023. In this instance, the scale of investment needed, as the Deputy said, is such that additional funding would be required to supplement these grants.
I fully understand and appreciate the value of our built heritage at a local level. I am eager to see the appropriate action taken in this case as soon as possible. In the past few days, I have asked officials in my Department to make contact with Dublin City Council on this matter. It is important in the short term to secure the building and prevent any further water ingress or damage to it. We are making efforts now to see if we can progress matters as a matter of urgency.
I thank the Minister of State. He is correct that there is supposedly mediation taking place. However, that has been ongoing for quite a long time. Ownership has been disputed since 2018 when the planning permission ran out. The problem is that one of the parties disputing ownership is in fact the local authority, the body that is supposed to protect the building under dispute. I brought the matter to this forum in the hope that Dublin City Council would listen and finally step in, secure the building and protect it from any further decay. It could then deal with the mediation in the meantime given that winter is coming.
The Iveagh Markets could be a fabulous resource for the city of Dublin and the country given the number of tourists who travel through the area but also for a community which has lost the Nicholas of Myra Hall, which is currently being used as a homeless centre, and another community hall, where there was a fire and will not reopen until 2025. The community is at a loss for space. The Iveagh Markets building is in such a perilous state that it could not be turned into a community area for many years. It must first be secured. Thankfully, the Guinness family stepped in and took control. It now pays for the security of the building. However, that is only security of the premises rather than security of the fabric of the building, which is in danger from snow, ice and water which can do tremendous damage to the iron pillars and the balconies that are rotting away. They need to be secured before they become totally useless for any rebuild in the future.
Again, I agree with everything the Deputy said. As a culchie who moved up to Dublin in the last couple of years, I cannot but be impressed by the architectural heritage of the city, particularly the older parts of the city such as the Liberties. The Iveagh Markets are intrinsic to that and an important asset for the people of Dublin and the country as well. Although deemed to be of regional importance, I believe the market is of national significance. It is critically important that we work collectively and collaboratively to try to find a solution to resolve this.
As I said, there are grant schemes in our Department. The local authority has powers under the Planning and Development Act to safeguard the building. There has been engagement from the Earl of Iveagh and others. That is really positive. The Deputy can rest assured that the Department will do all it can to try to move the process along in a positive way, not to look back but to look forward, and see if there is a mechanism by which we can get into a space where we can look at restoring or beginning the process of carrying out building condition surveys and getting a restoration project off the ground for the Iveagh Markets. The building is far too important for Dublin and the country to lose it. We will do all we can to try to help with this process.