Dáil Éireann - Volume 591 - 02 November, 2004

Leaders’ Questions.

  Mr. Kenny:Ten days ago this House united in the common objective of pleading with the captors of Margaret Hassan for her early release to the safety, comfort and love of her family. I thank the Taoiseach for his courtesy in briefing me that another video about this matter has been produced and given to the Al-Jazeera television station. Margaret Hassan is not sitting in silence in her cell. I understand this video is quite disturbing and shows Mrs. Hassan being subjected to severe physical and psychological pressure. She is shown to suffer severe emotional and physical distress. We have all heard of the work of Mrs. Hassan, an Irishwoman by birth and Iraqi by marriage and adoption. Her work has been described as goodness itself. That goodness apparently means nothing to her captors. They appear to be intent on exploiting her work to maximise publicity for their cause. I take this opportunity again to reiterate to the Taoiseach, on behalf of those on this side of the House and, I am sure, other speakers, as representatives of the Irish people, the affection and concern we share for Mrs. Margaret Hassan. While I understand Margaret Hassan’s captors use the Koran as part of their defence, in the Christian world this is All Souls Day and this is her hour of need. Perhaps the Taoiseach will give an update on the contacts, official or unofficial, the Government has had with authorities and organisations in Iraq to help bring about her release as an Irish and an Iraqi citizen.

  The Taoiseach:I had an opportunity during the day of briefing both Deputy Kenny and Deputy Rabbitte in the limited time available. Around lunch time yesterday, the family of Margaret Hassan were made aware that there was a further video from Margaret’s captors and that it was in the hands of Al-Jazeera. As Deputy Kenny said, it was a distressing video and it was decided by the station, on humanitarian grounds, not to show it but it made it available early this morning, with the text of what was on the video. I have not seen the video but I have seen the text, and a report of the text has been outlined to me as well. A number of dangerous and serious things, and timescales, have been stated in that.

I thank the House for reiterating again what we said here just short of two weeks ago — it is two weeks ago today that Margaret was taken. I had a meeting today with her family — her sister from Kenmare, her brother from Cork and her [738] two sisters who are based in the London area — and at their request and in their presence I made a direct appeal to the people holding Margaret to release her and allow her return to her husband, Tahseen. I thank RTE for going to considerable effort to make sure that appeal was communicated to Al-Jazeera for circulation and presentation. I hope the words of this House can be conveyed as quickly as possible.

The appeal, and our efforts here, is to the international media but mainly to the key Arab media organisations. That is what the family requested us to do. They stressed her devotion to the Iraqi people and to the humanitarian work she has done on their behalf over many years. Obviously, this is a very difficult time for her family and I assure them that the Government and the Opposition parties, who had a special debate here, will do all they can on Margaret’s behalf.

In reply to Deputy Kenny, the family is particularly concerned. This is an Iraqi family. Margaret’s husband is Iraqi born but he holds an Irish passport. She is a citizen of Ireland and her family are Irish. The family want to ensure that people in the Arab world understand that they are Irish and Iraqi. They made that clear in their statement. They pleaded that their sister would not be hurt. She spent her life working in Iraq, not for any political organisation or pushing any political views. All she has done is help the poor and the homeless in her adopted city, the city of her husband. I join everybody in the House in making this appeal and I appeal directly to those holding Margaret to release her and allow her return to her husband and family, and her brothers and sisters, who are extremely concerned about the latest position.

  Mr. Kenny:The House should again respond to the pleadings of Margaret Hassan’s family on this day of world political importance. It is opportune to focus on her Irishness and her Iraqiness. It should be remembered that Irish organisations played a major part over many years in working in hospitals in Iraq and helping the Iraqi people. Margaret Hassan’s work during her adult life has been totally dedicated to the benefit of Iraqi men, women and children, and the Taoiseach should use his efforts to ensure that the words of the representatives of all the people of Ireland expressed in this House today are broadcast, if possible, on the Al-Jazeera television station in a desperate effort to bring some sanity to this situation. Time is of the essence, but time may be short and in that sense I support fully the efforts being made by the Government to bring about Margaret Hassan’s return to the safety and love of her family as soon as possible.

  The Taoiseach:I appreciate the support of Deputy Kenny. I appreciate also the support of Deputy Rabbitte and, I am sure, that of every Member of the House. I did not have time to consult everybody, I would have done that if it were possible. Margaret Hassan has done humani[739] tarian work and we will make an effort to have the views of this House conveyed — I think we can do that — to the Arab network. I thank those in Jordan and Egypt who have been very helpful to us, and the Palestinian Foreign Minister who has made a direct appeal. Over recent days efforts were made through the humanitarian aid organisation on the ground. We did not want to interfere with those efforts but today we make a direct appeal to her captors in response to the entire family asking us to make this effort in Dáil Éireann. We do that and will continue to make every effort we can to assist Margaret.

  Mr. Rabbitte:The Irish Parliament is united in this plea for the early release of Margaret Hassan. She is an Irish citizen who has devoted most of her working life to humanitarian work for the weakest and most vulnerable people in Iraq. I speak as the leader of an Irish party that has consistently opposed the illegal war in Iraq and expressed solidarity with the Iraqi people in all their suffering over the years. I join the Taoiseach and the Fine Gael leader in asking for a positive response from people in this Parliament who are friends of the Iraqi people to the request that Margaret Hassan be released forthwith.

I raise with the Taoiseach the discovery by the Tánaiste over recent days that there is a problem with people being inappropriately accommodated in acute hospitals who might better be located in step-down facilities. The Tánaiste told us there are 250 such patients on any given day in the Dublin hospitals and that she has decided this is one way to make progress in terms of relieving the pressure on acute hospitals.

We have all known about that for many years. The Tánaiste’s predecessor, Deputy Martin, knew all about it when, on 29 July 2002, he announced the provision of 850 additional beds in community nursing units within three years. The Tánaiste now says, in answer to my colleague, Deputy Stagg, that not one of those beds has been provided but that she will examine it in detail very soon. We all know the Minister, Deputy Martin, ran the hospital service on the basis of announcements and reports, and that his presentation was usually extremely slick and clever. Will the Taoiseach explain how two years’ after this particular announcement, made on 29 July 2002 to provide 850 additional beds to accommodate what are crudely called bed blockers, not one bed has been provided? Why did the then Minister for Health and Children, Deputy Martin, make the announcement? Why did he go down the road of public private partnerships to alleviate this acute need? What is the reason for the delay?

At the time, it was specified that the community nursing units would be located on public land. The Tánaiste is making announcements that she will sell off this public land, assuming there is anything left after the Minister of State at the Department of Finance, Deputy Parlon, is fin[740] ished. He would sell Christ Church Cathedral if he thought he would get away with it. Where will the community nursing units be established? When will they be established? How has a project announced with such fanfare by the previous Minister for Health and Children been discovered by his successor not to have provided a single additional bed?

  The Taoiseach:We all know that the provision of step-down services for patients ready to be discharged from hospital is a key element of ensuring that health services are matched exactly to patient needs. It is a priority to increase the availability of community nursing and other units which would meet the needs of people who need care and would not be adequately provided for at home. As the Deputy stated, the Minister made the announcement in question two years ago. Work on the proposal for a public private partnership investment for 850 beds in community nursing units in two locations has continued in the Departments of Health and Children and Finance where discussions on how best to obtain the beds, whether through a PPP scheme with a developer or by some other means, continue.

As the schemes are complex, it is important to have a clear view of the benefit which would accrue given the complexity of the PPP structure. Instead of constructing the units, the previous Minister and the Tánaiste and Minister for Health and Children have continued, in 2003 and 2004, to use a better, more direct approach of providing money to the health boards and, in the most pressing area, the Eastern Regional Health Authority to facilitate the discharge of some 280 patients, mainly elderly people, into private nursing homes and other more appropriate settings. An additional €5 million was provided in recent months to facilitate the transfer of a further 200 patients, including some chronically disabled patients. In August this year the Department provided a further €3 million to the ERHA to transfer a further 120 patients.

I understand the Tánaiste stated in a recent parliamentary question that she was examining whether the work being done on the PPP is the best approach to this issue or whether it would be much quicker and better to continue to try to use the facilities already available, as has been the case for two years, and transfer patients directly. The Department of Health and Children takes the view that having some stand alone community nursing units outside the private area is a better approach. This is the issue the Tánaiste and Minister for Health and Children is examining and on which she will report back.

None of the 850 community nursing home beds has emerged using the public private partnership approach. We have taken a different approach by sourcing and using the facilities in the private sector.

  Mr. Rabbitte:The Taoiseach has rambled off into a number of areas about which I did not ask [741] him. I referred to a particular announcement by the former Minister for Health and Children, Deputy Martin, that he would provide a number of 50-bed community nursing units specifically for the purpose I have outlined. Not one of the beds has been provided, as the answer to a parliamentary question on 28 October makes clear, nor has any work been done — certainly not according to the reply — which suggests a breakthrough is imminent.

Why was it resolved to go down the PPP road? When will beds come on stream? The Taoiseach said he knows all about the issue and noted the Tánaiste is examining whether the PPP route is the correct one. Her predecessor made the announcement with much fanfare in July 2002. The Taoiseach seems to want to give the impression that he has just moved over to the Government benches and somebody on this side is responsible for this matter. I do not care when the Tánaiste became Minister for Health and Children. The Government has been in power for seven and a half years and we still have a crisis in the health service.

My questions relate to a specific announcement by a specific Minister. The Tánaiste, the current Minister for Health and Children, stated she would examine the matter in detail very soon. When will the beds come on stream? Where will they be? How many will there be? Why did the Minister go down the PPP route? Is the public land in question still available? When will the crisis in our acute hospitals be alleviated?

  The Taoiseach:The public land, which belongs to the Department of Health and Children, is available. The question which has arisen between the Departments of Finance and Health and Children is whether this is the best way of providing stand-down facilities or whether it would be better to use facilities available on a contract basis with the hospitals. That is what has been happening in 2003 and 2004.

The Tánaiste has the benefit of the work undertaken on the PPP process in doing this. As the Deputy is aware, we have had a number of difficulties with some of the PPP schemes in a number of areas. The Tánaiste must report on whether this is the best, most cost-effective and speedy approach. In the meantime, we continue to discharge patients from hospitals and the State, through the ERHA and the health boards, continues to fund their beds in different private facilities. The argument is that we should continue to do this as it may be a better approach.

  Mr. S. Ryan:Elderly people will wait 20 years to get into a nursing home if that is the case.

  Mr. J. Higgins:The National Maternity Hospital at Holles Street has declared that next year it will put a monthly limit on the number of births allowed to take place in the hospital. Today’s edition of The Irish Times refers to a comment by Dr. Peter Boylan, a consultant [742] obstetrician in the hospital, speaking on the “Morning Ireland” programme, that the Department of Health and Children has been aware of the pressure on the hospital for at least ten years. He also stated: “The persistent answer we get is you’re fine, you don’t need more people, you don’t need more nurses, you don’t need more doctors, the hospital is fine, go away and stop annoying us.” The Minister for Justice, Equality and Law Reform told the House last spring that the maternity hospitals were bursting at the seams with alleged baby tourism. He constructed a referendum he said would resolve the problem, held it and had it passed. Then we hear the comments I cited from a consultant in the premier maternity hospital. If the Minister was correct, what has happened? Was the whole episode a propaganda hoax by the Minister and the Government? Will the Taoiseach explain the matter?

Dr. Boylan also recommended that expectant mothers showing up at Holles Street Hospital and unable to receive care should visit their local Deputy.

  Mr. F. McGrath:They cannot deliver.

  Mr. Rabbitte:It is another form of family planning.

  An Ceann Comhairle:Allow the Deputy to continue without interruption please.

  Mr. J. Higgins:I presume he meant they should approach Deputies from the Fianna Fáil and Progressive Democrats parties since they are in power. It occurred to me that the Ceann Comhairle might advise the Houses of the Oireachtas Commission to assign each Government Deputy a qualified midwife, rather than a researcher. At least they might make a positive contribution to an aspect of the health crisis. It certainly would allow what is now called “advice centres” to be properly labelled “TDs’ clinics”.

  Mr. Rabbitte:Delivery units.

  Mr. J. Higgins:What is going on? What will the Taoiseach say to reassure people who will be in this difficult and nervous situation next year? If that happens in Holles Street, will resources be available elsewhere? What is the plan?

  The Taoiseach:Dr. Boylan is correct that the number of births increased between 1998 and 2003 by 8%, a large increase. For the preceding 20 years the number of births had been decreasing. There has been a number of meetings between the Department of Health and Children and the National Maternity Hospital in Holles Street. The last meeting was held on 22 July this year, when the Minister met the representatives of the National Maternity Hospital.

Proposals were approved at that meeting for interim developments aimed at relieving the infrastructural deficits. The measures are [743] designed to increase capacity in delivery rooms, neonatal, ICU and theatres, as well as improving the postnatal facilities for mothers and babies. The Department of Health and Children, the ERHA and the hospital have progressed the proposals through the hospital project team which has been in place for some time. The Department has approved the appointment of staff to oversee and manage the project and the process of selection of a design team to progress the improvement works at the hospital. The works are under way.

Deputy Higgins’s assertion that people have been told to go away is not in line with the facts, either in the past or more recently. The Department is advised that the ERHA has worked closely with all three hospitals to address the pressures caused by the increase in the number of births over the past five years after years of the numbers declining. This affects the Coombe and Rotunda hospitals as well, so the Department is dealing with all three.

  Mr. J. Higgins:Will the Taoiseach answer the point I made with regard to the assertions of the Minister for Justice, Equality and Law Reform about the pressure that was allegedly put on the maternity hospitals as a result of the law at that time? Has anything altered fundamentally? If the Minister for Justice, Equality and Law Reform was correct, there should be less pressure. The Taoiseach should explain that contradiction, for a start.

Sometimes it is hard to follow the Taoiseach when he answers — I use that word advisedly — our questions. Is the Taoiseach saying there will not be a limit or a necessity to impose one in Holles Street next year? What has he to say about catering for the need of every expectant mother to be properly looked after and treated?

  The Taoiseach:With regard to the first question, I made it clear that the number of births had increased by 8% in the three maternity hospitals in a four-year period. This is a reversal of what happened over preceding years. If the Deputy is asking me for the relevant figures since the referendum, I do not have them. However, the number of births increased considerably and that was Dr. Boylan’s point, which was correct. It increased from approximately 21,000 to more than 23,000 births.

With regard to what is happening, the Department has approved the appointment of staff to oversee and manage the project to increase capacity in delivery rooms, neonatal, ICU and theatres, as well as improve postnatal facilities for mothers and babies. The Department has also progressed the proposals with the project team. That work has been ongoing for some time. The last meeting of which I have a record was held on 22 July. As I understand it, the work Dr. Boylan wishes to see take place is at the design team stage. Obviously, the units must be built. One [744] cannot simply click one’s fingers and make them appear.

  Ms McManus:What about the women?

  The Taoiseach:The work has been approved and is being processed.