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Seanad Éireann debate -
Wednesday, 24 Jan 2018

Vol. 255 No. 7

Commencement Matters

Flood Relief Schemes Status

I know there are many demands on the Department in respect of flood relief but this matter goes back to 2012 when the Meadowbrook estate in Glanmire, County Cork, was badly flooded and some houses were under between 4 ft and 5 ft of water, with extensive damage done. The estate is alongside the Glashaboy River and it was decided there was a need for a flood relief scheme. A lot of work was done to prepare for the scheme, with an open discussion and presentation taking place in November 2016. The scheme was to provide protection for more than 78 houses and businesses along the route but we are now in 2018 and there is concern about the scheme. It needs to be prioritised and everyone in the estate is concerned that a freak thunderstorm or extensive rainfall would hit the estate again with flooding. Some residents did not have insurance at the time of the flooding, which meant they had major challenges. The damage was such that some houses had to be totally refurbished and some people have still not got over the incident.

I thank the Senator for raising this matter today and I am pleased to provide an update on the Glashaboy flood relief scheme, Glanmire, County Cork. Good progress is being made in advancing this much needed scheme. I have visited many of the areas in Cork that have experienced flooding and I am fully committed to ensuring that the flooding problems in these areas are dealt with as quickly as possible.

The Office of Public Works, OPW, in partnership with both Cork City Council and Cork County Council, recognised the high levels of existing flood risk in the River Lee catchment and carried out a catchment flood risk assessment and management, CFRAM, study for the Lee catchment which includes the Glashaboy River catchment. The draft catchment flood risk management plan was published in February 2010, and this identified a preferred option for the alleviation of flood risk in the Glashaboy catchment. Following significant flooding which occurred in June 2012 in the Glanmire-Sallybrook area, Cork County Council commissioned consultants to develop a flood relief scheme for Glanmire-Sallybrook. Cork County Council is progressing the scheme with funding from the OPW.

As the Senator will know, the locations identified in this scheme include the Sallybrook industrial estate, Hazelwood shopping centre, the Meadowbrook housing estate, Butlerstown, Glenmore and Glanmire Bridge to O'Callaghan Park. Following detailed assessment by the consultants, measures were identified to address flood risk in the area, including direct defences, for example, walls and embankments, culvert upgrades, flood relief culverts, channel widening, clearance of bridge eyes and road regrading. The scheme will benefit 103 properties in total, a total of 78 residential properties and 25 commercial premises.

Two public information days were held in February 2014 and February 2015 and submissions were considered by the design team. Subsequently, as the options were developed and the necessary environmental and engineering reports were prepared, the formal public exhibition of the Glashaboy flood relief scheme took place in November and December 2016, showing the preferred option developed by the consultants. The members of the design team were available for the public to discuss all aspects of the scheme. As part of the exhibition process, submissions were received from the public on the scheme proposals.

The Glashaboy flood relief scheme will be submitted to the Minister for Finance and Public Expenditure and Reform for confirmation under the arterial drainage Acts in the coming weeks. This is the final element of the planning process for the scheme. As the Senator will be aware, there is a significant procurement process to be undertaken in bringing the scheme to construction stage. It is anticipated that construction will commence before the end of this year. In the interim, Cork County Council is undertaking a number of preliminary contracts such as tree felling, in respect of which a contractor has been appointed. Once ground conditions improve, he will mobilise to the first two works areas, which are Meadowbrook and upstream of the Hazelwood Avenue bridge. This is anticipated to be within the coming week, depending on weather and ground conditions.

Bridge clearance and the clearance works in Glyntown Bridge were completed in November 2017.

Japanese knotweed, an invasive species, presented issues in a number of our schemes and a contractor has been in place for two stages of the treatment of Japanese knotweed and other knotweed variants. Work was carried out within the catchment area in August and September 2017. In addition, other advanced works have been carried out in respect of sensitive ecological receptors such as otter holes to minimise delays on the main contract. This advanced work will greatly enhance the progress of the project when the contractor is appointed. The progress of the scheme will offer great comfort to residents, businesses and homeowners in Glanmire as well as other towns such as Mallow, Fermoy, Kilkenny and Clonmel where major OPW schemes have been built to offset the severe weather and rainfall will no longer cause alarm and distress.

I assure the Seanad that the Government, through the OPW and local authorities, will continue the existing high level of investment in flood relief works and ensure that this very important area of works will receive the highest priority and attention now and into the future. I look forward to going to Cork to announce the Glashaboy flood relief scheme formally later this year.

I thank the Minister of State and appreciate the comprehensive reply he has given. He outlined the historical background and the work which has been done and which needs to be done. My only issue is that the residents want action. The more the Minister of State can do to bring forward the tendering process and the commencement of the works the better, and it would be very much appreciated.

I again thank the Minister of State for his comprehensive reply and look forward to working with him on this and other schemes in Cork. They are very important for the residents in the area who have suffered a great deal in an unusual situation in 2012. They are still recovering. They feel it is very important for the scheme to go ahead.

I can assure the Senator that no one knows more about the hardship which has been caused to these people than I do because I have visited many of the areas affected. I fully appreciate where the Senator is coming from. He does a lot of good work in the area. I assure him that as soon as we get approval, I will ensure engineers from the OPW work with the local authority to speed up the delivery of the scheme. It has been on the table for a long time, but these schemes take time. I know the stress the delay has caused. I wish to assure all Senators that where flood relief projects are highlighted and there are calls for a project to get up and running, I will be to the fore in making sure that they are delivered as soon as possible.

Public Transport Provision

I thank the Minister for coming to the House today. I appreciate it because I know he is quite busy. My Commencement matter states quite clearly what my question is.

The Greater Dublin Area Transport Strategy 2016-2035 identified a number of light rail projects, including the extension to the Luas from Broombridge to north of Finglas. I have been contacted by the chairperson of the Dublin 11 Luas campaign, Paul McAuliffe, who has brought together residents and community groups. They have launched a website, d11luas.com, to ask whether the Minister can now identify funding and a project team to deliver the project. With the metro north line planned to link the city to the area of Ballymun and M50, the Dublin 11 Luas campaign believes that the Luas green line should now be extended from Broombridge to the Ballymun metro line via the Finglas and Charlestown area. The campaign held its first meeting last week, which saw resident groups from all parts of Dublin 11 supporting it.

The group has also called for better park and ride facilities at Broombridge and better pedestrian access in the short term to allow those in the Finglas south area better access to the current services. More and more people are moving to the area and commute to work and college regularly. Given that road capacity is overstretched at the current time, it is an exceptionally important service. We are curious as to the general plan for the area.

I thank Senator Davitt for raising this very important issue. I mean that genuinely. It is quite striking that since the extension of the Luas in early December, everybody wants a bit of it. It is a big success story, and I am not claiming credit for that on behalf of the Government or anybody else. The Opposition supports the project. We would like to be able to extend the Luas much further because it is working and is a particularly successful and modern way of travelling. It is obviously part of the Government strategy and is probably supported by the Opposition. It should be one of the ways of getting people out of their cars and into public transport. It is a successful part of that plan.

The idea behind this Commencement matter is to co-ordinate the Luas with metro north, which is a very fine aspiration but may present some difficulties, certainly in the short term. That does not mean that the campaign to which the Senator referred should be discouraged. I do not think it should be and it is welcome that more people want the Luas in their area or a short distance away and want to extend it to their area or co-ordinate and integrate it with the rest of the public transport network. I welcome the fact that the group was set up. Although I cannot satisfy it immediately, I will endeavour to hear what it has to say and will go to its website.

As the Senator is aware, investment in the public transport network is a key priority and the Government has worked tirelessly in budget 2018 to secure an enhanced four-year capital envelope of €2.7 billion for public transport over the period 2018 to 2021. This funding will progress key capital programmes that will help address congestion and emerging capacity constraints on our public transport system such as additional capacity for the Luas green line, BusConnects, the DART expansion programme and the new metro north, as well as other programmes to fund active travel through walking and cycling investments. A commitment to protect investment has already been made in respect of our rail network.

With the permission of the House, I would like to spend just a little time explaining the benefits that each of these major projects will bring for the commuting public. The recently opened Luas cross city will add an estimated 10 million extra journeys every year on the Luas network. In addition, the green line capacity enhancement project recently approved by the Government will address current capacity limits at peak hours on the Luas green line and cater for future demands along the line. The success of the latest Luas cross city this week has been quite staggering and has presented almost immediate problems because so many people want to use it. In the next two weeks we will introduce new and extended trams to cater for the increased demand. It is a tremendous thing to be a victim of one's own success.

The four-year capital plan provides for investment of more than €770 million to progress the BusConnects programme launched last summer by the National Transport Authority, NTA. BusConnects will completely overhaul our bus system to help address growing congestion in the Dublin region in the short to medium term. In addition to providing a considerable improvement in bus infrastructure, it also includes cycling and walking facilities along the key corridors. Work is ongoing on proposals for the redesign of the bus services network and infrastructure proposals for core bus corridors. I am pleased to inform the Senator that I expect the public consultation processes to begin on these new proposals in April and May. That will have a great deal of appeal to those citizens who live in the neighbourhood to which Senator Davitt referred.

Funding of €230 million over the period 2018 to 2021 is allocated for mainline rail projects, including the city centre resignalling project, the national train control centre and DART expansion. The funding will initially provide additional fleet to enhance capacity, and allow substantial progress on electrification of the northern rail line as far as Balbriggan that is expected to be delivered in 2022.

Lastly, funding of over €460 million has been allocated to continue planning and design to allow construction of the new metro north to commence in 2021, with passenger services starting in 2027. Design and planning work is already under way. I expect that the public consultation process on the emerging preferred route will commence in a few weeks' time.

All these transport schemes are being delivered under the National Transport Authority's transport strategy for the greater Dublin area 2016-2035, to which the Senator referred. This provides a framework for the planning and delivery of transport infrastructure and services in the GDA over the next two decades. The delivery of these projects is obviously subject to a number of influencing factors, including funding availability. The strategy also includes a number of proposals to further develop the light rail and metro network in the GDA. While this includes the extension of Luas cross city from its terminus at Broombridge to the north of Finglas to provide a high capacity radial service from this large suburb into the city centre, it does not foresee a direct connection with metro north.

Having said that, the programmes I have set out will serve the significant levels of forecast travel demand from this corridor to the city, and deliver a transport network that will provide high quality passenger interchange points, which facilitate convenient transfer between efficient and integrated public transport services. All these initiatives combined will add greatly to the choice and experience of the travelling public and ease congestion in the greater Dublin area.

I thank the Minister for his very comprehensive reply.

There is a slight bit of light in the Minister's reply because he said that work is ongoing on proposals for the redesign of the bus services network and infrastructure proposals for core bus corridors. In other words, his Department will take proposals on same. The Minister and the Department have enjoyed so much success with the roll-out of the Luas project that it is now causing headaches. This area of public transport has been under-resourced. The numbers prove that the core public transport infrastructure is very slight in the area. Mr. Paul McAuliffe and his group will make submissions and will push their plan. They appreciate the Minister's support and his willingness to listen.

Their submissions will be more than welcome and they will be certainly listened to. I do not want to hold out any short-term hope because it would be unrealistic. The development of transport is very exciting and the sky is the limit.

I thank the Minister and Senator Davitt.

Services for People with Disabilities

I welcome the Minister of State at the Department of Health to the House and thank him for coming here to discuss this important issue. I tabled my Commencement matter because I want to know how many children with severe disabilities await placement in residential care. Some of the children have reached a certain age and they no longer quality for some of the services that are provided by the Jack and Jill Foundation, etc. Let me give an example where both parents work and they have a six-year old daughter with multiple disabilities. She is brain damaged so cannot walk, talk or communicate and must be PEG fed. Even though both parents work, they have more or less been advised that the girl's father should give up as the family would be in a better position to qualify for a lot more services. The parents care a great deal for their daughter. They provide care 24-7 but do not receive any assistance because they both work. There are two more children in the family. The parents were given medical cards for those children but, unfortunately, the medical cards have been taken away. The medical cards allowed the parents to receive some money to pay crèche fees. The family has a lot of expenses and outgoings. Their daughter is also getting older and is so severely disabled that they are on a HSE waiting list for permanent residential care. Their daughter now suffers multiple seizures. Her parents have been trained to cope with her seizures as, unfortunately, they cannot always have a nurse with her at such times. As the seizures have become more frequent, her parents have been advised to get their daughter into full-time residential care. Unfortunately, there are no residential places available and no indication when the issue will be resolved.

I tabled my Commencement matter to highlight the plight of this family and they gave me their permission to do so. There are more cases of people in need. Children should be prioritised in terms of residential care, especially when they suffer multiple disabilities.

I thank Senator Byrne for raising this important issue. I also thank her for giving me the opportunity to outline the position in terms of the provision of residential services for children in the Limerick and Tipperary area. I am informed by the HSE mid-west community health care that seven children await to be placed in full-time residential care - five in Limerick and two in north Tipperary.

Disability service provision is moving towards a community-based and inclusive model rather than being institutional and segregated. The Government's objective is to deliver disability services that are person centred. Being person centred is about putting those who use our service at the centre of all our activities. It is about listening to people or their advocates and transferring our focus from the service to the people who use same. Our policy is for people with disabilities to be supported to achieve their full potential so that, where possible, they can live ordinary lives in ordinary places doing ordinary things.

The HSE has recognised that first class early intervention services and services for school-aged children with a disability are paramount and need to be improved and organised more effectively. This process is well under way nationwide.

The HSE is currently engaged in the reconfiguration of existing therapy resources under the national programme on progressing disability services for children and young people. The aims of this programme are to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children and their families to disability services, regardless of where they live, what school the child attends or the nature of the child's difficulties.

Increased demand for residential places is acknowledged by the HSE as a challenge for all service providers arising from the lack of availability of development funding during the economic downturn. It should also be noted that given the introduction of the national standards for residential services for children and adults with disabilities, every new residential centre must now be approved by the Health Information and Quality Authority, HIQA. All centres providing residential services, including respite services, to children and adults with disabilities now need to be registered with HIQA by law. Each centre will be visited by HIQA inspectors to ensure that they provide an appropriate standard of care.

The need for increased residential facilities is acknowledged. The HSE continues to work with agencies to explore various ways to respond to this need in line with the budget available.

We want to ensure that people with disabilities are safe and empowered to maximise their potential through respect and understanding. This means that services will be delivered through a range of options in line with those available to the wider population.

I thank the Minister of State for his response but it does not resolve the issues faced by the family I mentioned. Their daughter is progressing very quickly and suffers seizures. I also highlighted the fact that the family lost the medical cards for two other children. Families in these situations feel vulnerable and need support, particularly when they await placement. An exception should be made for the seven families I mentioned in my Commencement matter. I am sure that there are many more families located around the country who are in similar position. The family I mentioned are finding life tough because they must provide care 24-7. They are delighted to provide care but they are approaching the stage where they will no longer be able to carry on and will have to bring in support. The parents must pay for such support because they do not quality for any services due to both of them working. However, they work because they must pay their mortgage and send their other children to school, etc.

They are going to have to pay for that support because they do not qualify for anything. Both parents are working but the reason they are doing so is that they have a mortgage to pay and have to send the other children to school, etc. Cases such as this need to be considered on their own merit. Families' circumstances need to be examined while they are waiting for long-term residential care. It does not look like there will be any provision in the short term to resolve this issue. There have been meetings with the HSE but nowhere suited to meeting the needs of the child in question has been highlighted or selected.

Perhaps the Senator could speak privately with the Minister of State and his staff to determine whether progress could be made on this. It is difficult to respond when raising a specific case on Commencement matters. Perhaps communication between the Senator and the Minister of State might result in progress of some kind. It is a difficult question for the Minister of State to respond to.

I thank the Cathaoirleach for that guidance and assistance. I will certainly work with the Senator and the HSE. I will connect with the latter and ask it to review the case the Senator is talking about. I stress that the difficulty is felt. While we can read scripts or whatever, we, as parents, politicians and leaders in our community, acknowledge the contribution of parents in cases such as this. It is extraordinarily difficult to do what they do seven days per week, 24 hours per day, with a scarcity of respite and a lack of residential places. Therefore, I will ask the HSE in the area in question to review the case and redouble its efforts to determine what we can do in the interim to provide as much support as we can to the family.

I would appreciate that. I thank the Minister of State.

As somebody with a close connection to somebody with a child with special needs, I believe the facilities available in west Cork and many parts of rural Ireland are far better than those available in Dublin. That is what I have learned in recent years. We have our disadvantages in west Cork but we have many good systems there also. We will move on. I thank the Minister of State and the Senator.

Hospital Waiting Lists

I welcome the Minister of State, Deputy Jim Daly, to the House. I would like to discuss the ongoing overcrowding in accident and emergency departments and the potential role of smaller hospitals, such as Monaghan Hospital, in alleviating the current problem. To put it mildly, it is very unsatisfactory to see thousands of citizens, most of them elderly, lying on hospital trolleys. We need new, imaginative thinking to address this.

I noted the recent comments of Professor John Hyland, the president of the Royal College of Surgeons of Ireland. He said the normal response when the number on trolleys increases is to cancel elective and non-urgent surgery. This is heartbreaking for those waiting on that surgery because many have been waiting for years. Many are elderly and many are in pain. They build themselves up for the procedure only to be told it will not go ahead. We make the decision to cancel elective surgery lightly but we sometimes fail to think about the consequences of such decisions. Therefore, we need new thinking if we are to address this. It is important that we concentrate on the role that small hospitals, such as that in Monaghan, could play in relieving the pressure in our major hospitals.

Monaghan Hospital had its services stripped. It was one of the first hospitals in the country to receive such treatment. There has been a follow-on in that other hospitals have had their services removed. In the case of Monaghan, however, a sledgehammer was used in that too many services were stripped from it. People realise that we cannot have major trauma surgery and other serious surgery taking place in a small hospital such as that in Monaghan but statistics indicate that 85% of people who present at accident and emergency departments could easily be treated elsewhere. Therefore, the time has come for new thinking.

It is welcome that the Minister of State is new to the job. He brings common sense to the role. It is time that we re-examined the smaller hospitals from which services have been removed. Monaghan Hospital is a prime example.

The current circumstances, whereby people are lying on trolleys for days on end, are very unfair. Yesterday, the number was the second highest ever. We need new thinking, as I stated. What is being done to the people involved, most of whom are elderly, is heartless. It is very unfair on the staff who are completely stressed because of their workload. I would like the Minister of State or the Minister to visit Monaghan to ascertain what services or potential exists within the hospital. There is a feeling that Monaghan Hospital could play a greater role in helping to relieve the current pressure in major hospitals.

Monaghan Hospital currently has a minor injuries unit. Before it was taken off call, it was a brand-new facility. It has considerable potential. We feel that Monaghan could be doing much more, especially at the medical end, to relieve the pressure on the major accident and emergency departments in Cavan and Drogheda.

There is a state-of-the-art theatre in Monaghan. Many thousands of euro were spent on it before it was taken off call. The theatre is totally underutilised. Professor Hyland made the point that when elective surgery is cancelled when the trolley numbers increase, hospitals that do not have accident and emergency departments, such as that in Monaghan, could have a role to play, rather than cancelling surgery. Beds could be ring-fenced so people awaiting non-emergency procedures could be dealt with in hospitals such as Monaghan Hospital. The pressure would be taken off accident and emergency departments as a result.

I would like the Minister of State to visit Monaghan and see the facility for himself. He should determine the potential that exists in order that Monaghan Hospital, along with other smaller hospitals, could play a role in ending the heartbreaking circumstances whereby people, mostly elderly, are lying on trolleys.

I thank the Senator for his contribution. He speaks a lot of sense. He issued an invitation that I would be delighted to accept. If he sends it to my office, I will be quite happy to ensure it is followed up. I would be very happy to visit Monaghan, as I have done previously in my role, because I have not seen the hospital there.

I agree with the Senator. I am a proponent of what he spoke about. If we always do what we always did, we will always get what we always got. If we are to be serious about bringing about real change and considering how to proceed differently, we need a new approach. As a Minister of State in the Department of Health, I very much welcome the role of public representatives in articulating alternative approaches. The Senator has a good sense of the local issues in his area and of the potential of Monaghan Hospital to make a real contribution to addressing the overarching issue of trolley numbers.

We must never forget that, while trolley numbers dominate many headlines, there are people on the trolleys. They face significant delays in gaining access to treatment. If there is a better way of proceeding, it is incumbent on us, as political leaders, and HSE management to work together through the Department of Health to ensure we explore the options. That is my responsibility as Minister of State. I will assist in this regard to ensure this avenue is explored.

The Cathaoirleach and I are very familiar with similar issues in west Cork. Bantry Hospital makes an enormous contribution to the well-being of people and has greater potential. The Cathaoirleach has for many years fought the battle in this regard. I hope to continue with it. I support the Senator very much and would like to see what is proposed happening.

As the Senator may be aware, Cavan and Monaghan hospitals operate within one hospital group servicing the local population, with the emergency department located in Cavan and the facilities in Monaghan focused on elective care and the streaming of appropriate patients to the minor-injuries clinic. At the end of December 2017, Cavan General Hospital was showing a 3% increase in attendances by patients 75 years or older by comparison with 2016. Furthermore, the admission rate grew by 7.7% in general in this period and by 5.2% for those 75 years or older. Notwithstanding growing demand, Cavan has seen the number of patients on trolleys decrease by 40% in the same period. We must always keep in mind that behind every trolley number, there is a real patient in need of effective, timely and compassionate care from our health service, as I said already.

In 2017 there were over 360 fewer patients waiting on trolleys in Cavan hospital by comparison with 2016. I accept that is still not good enough. While it is a positive indicator, there is certainly farther to travel. I absolutely accept that. There is a tangible improvement but we must continue to try harder. Therefore it is essential that we share the learning and experience of hospitals such as that in Cavan and the RCSI hospital group across the system.

In October 2017, the HSE organised a winter ready conference, which gave all hospital groups and CHOs an opportunity to share best practice and their plans for this winter. I assure the Senator that the Government remains committed to driving this type of improvement in all emergency departments nationally.

I thank the Minister of State for his response and welcome his commitment to visit Monaghan. I will contact his office to arrange the visit as soon as possible. He has said we cannot keep doing the same things and expect different results. I am heartened by the fact that he is a doer rather than a sayer because this problem requires new thinking and somebody to lead the HSE away from its current way of thinking. It was a mistake at the time to strip Monaghan General Hospital of all services because it has a genuine role to play and I would not be wasting the Minister of State's time if I thought otherwise. I would like him to visit with an open mind and look at the facilities available, including the state-of-the-art operating theatre and the minor injuries unit, to get an idea of the hospital's potential. Such a visit would be worthwhile and lead someone like the Minister of State to drive the HSE to change and look at things afresh. It must look again at smaller hospitals such as Monaghan General Hospital and the positive role they could play in helping to reduce the heartache associated with hospital waiting lists and patients on trolleys.

Monaghan General Hospital is a little like the hospital in Bantry. It is a chestnut that has been around for a long time, but it is still functioning. I thank the Senator and the Minister for State. I am sure the Minister of State will honour his commitment to visit the hospital and that his visit will have a positive outcome for the people of County Monaghan. It is not too long since a Member was elected to this House on the back of a campaign related to the hospital. This is an important issue in the county.

Sitting suspended at 11.15 a.m. and resumed at 11.30 a.m.
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