John Gormley

Deputy Gormley: I welcome the Tánaiste and her officials to the meeting. When I addressed the Taoiseach this morning, I stated that the Green Party would not support the dumping on civil servants. When the Tánaiste spoke a few weeks ago about maladministration, I am on record as saying that the way was now being prepared to find scapegoats. I am afraid this is what has happened.

Deputy McManus: That is correct.

Deputy Gormley: It is a feature of this Government. We have had reports on Punchestown and on the hiring of a public relations executive by the Minister for Transport, Deputy Cullen. Now we have the Travers report.

The Tánaiste should contrast this situation with the speedy action taken by Deputy Phil Hogan when, as Minister of State, he was found to have made an error. Deputy Hogan did not blame civil servants bur rather made the correct decision by resigning from office. By contrast, there is a tendency on the part of this Government to brazen it out. In this instance, civil servants have been asked to take the rap. Does the Tánaiste believe this is correct and proper behaviour? She was the person who went into Government promising to keep an eye on these types of issues. Her party claimed that Fianna Fáil could not be trusted to govern alone. She has an opportunity today to say what she thinks of all this.

This report exposes a monumental and chaotic mess and shows that the interface between civil servants and the Ministers involved was extremely confused. The meeting that took place on 16 December 2003 was attended by the Minister of State, Deputy Callely, who said he was going to talk to the Taoiseach but seems to have had only a brief discussion. The Minister of State, Deputy Tim O’Malley, was also there and says he assumed progress would be made on the issue. Is this Government on the hoof? It seems to be an Administration in which people make assumptions.

I hear Deputy Callely is excellent at following up in his constituency where he has the reputation of being reliable in responding to queries. However, where was the follow-up to this meeting? Why did the Minister of State, Deputy Tim O’Malley, assume progress was being made? Most important, why did the Minister, Deputy Martin, just assume matters were ticking along nicely?

The Tánaiste has eulogised civil servants today. However, it appears it is only they who will take the rap on this matter. Does the Tánaiste trust the Secretary General? I ask her not to beat about the bush in her response but to offer a simple “Yes” or “No”. If the Tánaiste does not believe the Secretary General’s version of events, that represents a major breakdown in trust between the Minister and her civil servants. If, on the other hand, the Tánaiste trusts the Secretary General, there are serious implications for the former Minister for Health and Children, Deputy Martin.

I note with interest the Tánaiste’s comments in regard to the Health Service Executive. There are many people in the Department of Health and Children who are not happy with the way the HSE has developed. The Tánaiste went on to say more resources are required for her Department. At least the Minister, Deputy Martin, was prepared to say he would introduce extra taxes in order to get more resources. The Tánaiste does not even say that and one must wonder how these extra resources will be secured.

This report has critical implications for the manner in which the Department will function from now on. Whatever about going back to 1976, there can be no excuse for the way the Government has acted since 2001 and especially in 2003 when legal advice was received in the form of an 80-page memorandum. The Tánaiste must take responsibility for her attempt to legalise theft. She is the one who brought legislation to that effect into the House. This issue has been a mess for the Government from start to finish.

Deputy F. O’Malley:  The Government has at least had the courage to face up to the problem.

Deputy Twomey: There has been no evidence of such courage.

Deputy F. O’Malley: This situation has been ongoing for years. Anybody who has read the report knows that.

Deputy Gormley:  I hope Government Members have the courage to ask for resignations.

Deputy F. O’Malley: Deputy Gormley should refer to page 39 of the report.

Chairman:  Deputy Gormley should be allowed to continue without interruption.

Deputy Gormley:  I hope the Government will not defend the indefensible and that the Tánaiste will have the courage of her convictions and ask for resignations in cases where people have misbehaved and have not taken their duties seriously.

Deputy Harney:  I am told the statement on the Secretary General was issued. I can, therefore, confirm that Mr. Michael Kelly is moving from the Department of Health and Children on a secondment basis to become the Chairman of the Higher Education Authority.

Deputy Gormley: That is scapegoating.

Deputy Gormley:  I thank the Minister for appearing before the committee. However, while she is good at identifying problems, she is powerless to do anything about them. When will the world class health service she promised be provided? What is the benchmark of her success? What does she hope to achieve before the next general election? She stated the problems do not relate only to bed capacity and she was asked when the 3,000 beds will be replaced. When will the 300 beds promised in the ten-point plan be provided, given that the Health Service Executive has been vague about this matter?

I refer to discharge policy. I was contacted by a man recently whose parents were in hospital. A number of weeks ago, a consultant said they were fit to leave and they could be looked after at home but the equipment they need is not there. They have spent six weeks in hospital, even though they should not be there. This is par for the course and it is unacceptable. What will the Minister do about discharge policy?

Does she agree the primary care policy is in tatters but it ought to be the cornerstone of a world class health system? However, she has stated more than 90% of illness could be addressed in her health strategy, the implementation of which is non-existent. When will a proper primary care strategy be put in place? Does she agree the basis of good health is good food, exercise and water?

The Minister stated in the past that the Progressive Democrats’ philosophy is liberal and it is about the individual.

Deputy Harney:  I never mentioned that.

In answer to Deputy Gormley’s statement about accident and emergency departments being the test of success, no matter what is done at tertiary level, with the acute hospital system or in cancer care, radiotherapy or rheumatology services, if patients have to wait on trolleys overnight before being admitted to a hospital bed, we will not be successful. I do not regard this as total reform; it is simply a question of acknowledging that if €11 billion is being spent and 14 or 20 patients have to spend the night on trolleys — last night I believe nationally the total was 180 — we are not being successful. There is no excuse when so much money is being spent.

The most effective method of changing the position is to put right all the causes. There must be development of out-of-hours GP services, more acute medical assessment units, greater usage of beds and a more rapid turnaround. I acknowledge Deputy Gormley’s point which was also made by others that there are patients in the acute hospital system, at a cost of over €5,000 per week, who need not be there. We want to find a more appropriate setting for them.

That brings me to the issue of long-term care. As the committee will be aware, there have been proposals that 850 beds be provided by the State. We are examining different ways of providing them. I hope to be in a position to make an announcement on the matter shortly.

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Deputy Gormley:  The Minister has stated this previously, not today. She referred to the importance of the individual and the need for less government, which she did mention earlier. How does that square with the idiotic policy of putting fluoride in our water? Should it be up to the individual to decide whether to take fluoride?

Deputy Harney:  We may have done a lot of bad things but we did not put fluoride in the water.

Deputy Gormley: This does not square with the Progressive Democrats’ philosophy. Each individual should decide whether he or she wishes to consume fluoride. Where this practice has been discontinued, there has not been an increase in dental cavities. The Food Safety Authority of Ireland has confirmed Dr. Hardy Limeback’s statement to the committee that fluoridated water should not be used to bottle feed babies but the fluoride forum overturned that decision. How can the FSAI and the fluoride forum reach contradictory decisions?

Chairman:  I ask the Deputy to conclude as he has gone over the time allowed.

Deputy Gormley: Will the Tánaiste take a fresh look at water fluoridation and will she, please, listen to me rather than speak to her colleague?

Deputy Harney: I was trying to get information for the Deputy, that is all.

Deputy Gormley: I appreciate that. I thank the Tánaiste.

Mr. Gormley:  I support Deputy McManus’s amendment:

                     [amendment No. 45: "after “1998” to insert the following:

“and provision shall be made to ensure that a detailed breakdown of the estimates of expenditure are available for scrutiny by the Committee of Public Accounts of Dáil Éireann”.]

 The Tánaiste has assured us repeatedly on Committee Stage of her interest in accountability and her desire to improve the legislation in this regard. This amendment, which deals with financial accountability, makes eminent sense and goes a long way to achieve that objective. It is one of several we hope the Tánaiste will accept. Like Deputy McManus, I do not see why it should not be accepted.

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Mr. Gormley: I move amendment No. 46:

In page 20, subsection (1), lines 42 to 44, to delete all words from and including “shall,” in line 42 down to and including “Executive.” in line 44 and substitute the following:

“shall come before the Joint Oireachtas Committee on Health and Children to discuss any matters raised by the committee on a bi-annual basis on dates decided on by the committee.”.

As I explained yesterday, the gremlins seem to have got into the Bills Office. This amendment was intended as an addition to the existing section rather than a replacement. The purpose of the amendment is to guarantee the opportunity for the committee to interview the chief executive officer of the HSE on a bi-annual basis. According to the existing section, the Oireachtas Joint Committee on Health and Children can request the chief executive officer to appear before it, and she or he shall have to do so. Perhaps I am being overly-protective.

Ms Harney:  This is ridiculous. The Deputy is suggesting that even if the committee does not want the chief executive officer to come before it, he should do so anyway.

Mr. Gormley: I am not saying that. I have listened to some of the Progressive Democrats Deputies on this committee, and they protect the Tánaiste.

Ms Harney:  Where are they? I do not need anybody to protect me.

Mr. Gormley: They are not here today.

Ms Harney: It is my job to protect them.

Mr. Gormley: Deputy O’Malley has done a great job on the Tánaiste’s behalf.

If the Tánaiste was to pressure the committee not to request the chief executive officer to come before it, she or he would not come. I would like to have it stated, in some mandatory manner, that the committee has an opportunity to interview the chief executive officer twice a year. It is obviously not phrased as I wish in the amendments. I must resubmit it on Report Stage as an addition to the section, not a replacement. I would like various Oireachtas committees to have the opportunity to make a written request for the chief executive officer to come before them. The chief executive officer must come before the Oireachtas Joint Committee on Health and Children at least twice a year. It is no reflection on the Chair. However, if a majority does not want it to happen, it will not. That is the problem.

Chairman:  Is the amendment being pressed?

Dr. Cowley: I included an amendment on the matter also, although I was a bit late. I proposed the chief executive officer should come before the committee on a quarterly basis. As the Tánaiste mentioned, the Department of Health and Children has a policy of fewer cooks spoiling the broth. I agree with the policy, but there must be accountability. The fear is that the Health Service Executive will be another quango such as the National Roads Authority. The Tánaiste will need a large complaints department. The situation has gone full circle from gross over-representation to complete under-representation and democratic deficit, so this is an important factor. It has been difficult to get Ministers for Health and Children to come before the committee. Promises have been made and broken. I realise Ministers are busy…I must go on my own experience, and other members will back me up. We have had great difficulty in getting Ministers to come before the committee.

Mr. Neville: There will be a different Minister in two years’ time.

Dr. Cowley: If it was stated in legislation, we would not need to depend on the Minister. I am not blaming the Tánaiste because she is new to this role. However, she is a busy person and has difficulty in coming before the committee. We had the same problem with the previous Minister so I must presume it will happen again. That is why it is important this amendment is included, and I intend to resubmit it on Report Stage. The chief executive officer should come before the Oireachtas Joint Committee on Health and Children on a quarterly basis.

Dr. Devins:  I am looking for clarification on a matter. According to section 21, “the chief executive officer shall, at the written request of an Oireachtas Committee, attend before it to give an account of the general administration of the Executive.” That means the committee can request the chief executive officer to come before it at any time, even if it was every week. Am I right in that assumption?

Mr. Gormley:  The problem is the Government parties have a majority on the committee. If their members decide not to call the chief executive officer, that is it.  There is Government and there is Parliament. We have rights as well.

Dr. Cowley:  Section 21 states that the chief executive officer shall give “an account of the general administration of the Executive.” We must be sure we can raise matters which are relevant and pertinent.

Mr. Gormley: There is a slight difference. The section refers to an account of the general administration of the executive. However, we should be entitled to raise questions we wish on any issue.

Dr. Cowley:  That is my point exactly.

Ms Harney:  I am sure when the caring alliance gets into power, its Minister will attend the committee every week, whether it is Deputy Twomey, Deputy McManus or Deputy Neville. Perhaps it will be a rotating Ministry, or a Deputy from the Green Party.

Mr. Gormley: I admire the Tánaiste’s courage in taking on the health portfolio.

Mr. Gormley:  I am sure we will.

Amendment, by leave, withdrawn.

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move ato amendment No. 47:

                In page 21, subsection (2), lines 3 and 4, to delete “has been or may at a future time” and substitute “is likely to”.

Mr. Gormley:  The Tánaiste spoke of a bureaucratic straitjacket. This is a straitjacket and a gag. Her party professes to be liberal, but there is nothing liberal about this measure. This would mean free speech would be gone down the drain. The ability to express an opinion which may be contrary to that of the Tánaiste would be gone and if, as a committee, we were to conduct proper interviews with the CEO, inevitably we would want the CEO to comment on matters which may lead to him or her making a statement that may contradict Government policy, but so be it. If we are to conduct our business properly as a committee — this goes back to the point I made to Deputy Devins — it appears that at every stage accountability is being diminished. Section 21(9) sets the tone for the chief executive officer and lets him or her know he or she had better tow the line and know where the Minister is coming from. On the one hand the Minister wants to give that person freedom, while on the other hand she wants to curtail that freedom.

amendment withdrawn.

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Ms Harney: That is not correct. It is not a question of making complaints. The issue is the transfer of information into the public domain. That employees are required to work on the basis of confidentiality does not mean they are required to cover up wrong-doing. That is a completely different scenario. If any such wrong-doing is covered up, the HSE is responsible. For example, if a public health issue is not given into the public domain, the executive must take responsibility for that failure.

Mr. Gormley: The problem, as the Minister observed, is that the definition of wrong-doing is subjective.

Ms Harney: Yes.

Mr. Gormley: In the case mentioned, the midwives’ claims of misconduct were denied by Dr. Neary who insisted that his actions were correct. This is the problem. There must be some facility for whistle-blowing. Perceptions of wrong-doing may well be subjective, as the Minister observed, but there must be protection for employees in this regard. Any possible instance of wrong-doing will produce disagreement as to whether the behaviour in question was incorrect. There any many examples of such controversies, including the issue of organ retention. The Minister cannot ignore this and dismiss the arguments of Opposition Members. We have made a legitimate point.

Dr. Cowley:  I acknowledge respectfully that the Minister, or any Minister for Health and Children, wants to do what is best. However, the role of the Minister for Health and Children is a very political one because that is the nature of the adversarial system in which we operate. It is important that doctors operate independently and that they and other health service employees can avail of a process that allows them to speak out.

The Medical Council’s guide to ethical conduct and behaviour states:

It is recognised that medical care must not be used as a tool of the State to be granted or withheld, or altered in character, under political pressure. Doctors require independence from such pressure in order to carry out their duties.

In this context, the legislation puts more pressure on the Minister for Health and Children, who will now call every shot. This concern is not directed personally at the Tánaiste. In the future, however, another Minister might try to do something in a political way. There is an onus to incorporate this amendment into the legislation to ensure that doctors can operate independently and speak out when such is required. There must be a facility that allows them to do so without fear of penalty.

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Mr. Gormley:  I move amendment No. 67:

In page 26, subsection (1), line 11, to delete “Minister” and substitute “Dáil”.

I asked on Second Stage that the Dáil should be given an opportunity to discuss and amend the corporate plan, and that it would not be a matter for the Minister to approve it and subsequently lay it before the House. It is a question of what role does the Dáil play in the process or is it simply a matter of the Minister liaising with the chief executive, and the whole thing remaining in that sphere, or will the Minister democratise it and broaden it out? I do not understand what good it will do if the Minister lays the corporate plan before the Houses of the Oireachtas which has had no input into it. There are two political philosophies at play here whereby the majority takes all, or does the Minister believe in Parliament having an input into the plan? The corporate plan lays down policy, therefore, Deputies elected to the House, and not just the Minister, should have an input into the plan.

Ms Harney:  The Oireachtas has been given a very central power, namely, the power to hold the Executive to account.

Mr. Gormley: How?

Ms Harney: Through the discussion we had earlier, first, in that the CEO is the Accounting Officer, responsible to the Oireachtas for how the money spent, second, through asking parliamentary questions and, third, through amendments I will table to strengthen the requirement of the CEO or senior management to come before the appropriate Oireachtas committee. However, we cannot have a situation where the corporate plan of a body, in this case a public body, would have to be approved by a committee of the Oireachtas.

Mr. Gormley:  By the Dáil itself.

Ms Harney:  That is not acceptable. One can approve the Vote and where the money is spent, but how an organisation organises itself and what strategies it pursues are matters of policy and matters for the Minister to approve, not matters in which the Oireachtas should be involved.

Mr. Gormley:  It goes back to our definition.

Ms Harney: Should the HSE have eight managers, not six or nine managers? These are all logistical issues to do with the implementation of the policy.

Mr. Gormley: It goes back to the old argument. We referred earlier to people being elected democratically to health boards, a practice which is to be abolished.

Ms Harney:  Health boards have virtually no power. The reserve powers of members were diluted substantially in 1996.

Mr. Gormley:  Some 166 Deputies are elected by the people who can vote us out if they wish. We, as elected representatives, should have some input into the corporate plan, or will this body remove more and more power from this House? The Government, which has a majority, has an input into the plan and more than likely will approve it. However, all of us should have an input into it and we should be able to amend the plan. It is so obvious, but clearly it is not obvious to the Minister. The Minister said that Members can table parliamentary questions, but I would like to specify the areas on which we can ask parliamentary questions. I believe we will see more and more letters coming back from the Ceann Comhairle stating that he is ruling the question out of order because it is a matter for the health executive. It should be enshrined in the legislation that what we can now discuss is not ruled out of order, so that if the legislation is passed we are not limited as we proceed.

I welcome the fact that the Minister has confirmed she will strengthen the accountability rules. However, a democratic input is lacking and the function of the House is becoming redundant. We can sit here and make observations about matters but our input is very limited. It is a matter for the Tánaiste in this case, and the Minister for Health and Children in the future, liaising with this person, coming up with a plan, subsequently laying it before the House and that is the end of it. We will have no more to say on it.

Dr. Cowley:  There is a democratic vacuum. Prior to this there were the health boards, CEOs and the plans were put before the elected members. However, there were problems in that the plan could not be agreed if the members did not agree with it. The Minister often had to make a decision, but at least a democratic process was in place. While I was one of the first Deputies to call for the abolition of the health boards, we have thrown out the baby with the bath water. The democratic baby has disappeared and that baby needs to be brought back. The vacuum needs to be filled.

While the Government has a majority, the Minister for Health and Children has taken responsibility for everything. Surely she should share the responsibility in a democratic way. Why is she afraid of democracy? It is about the Minister taking on the responsibility herself, which is not right. We are all elected to do a job and things will be happening throughout the country into which Members of the Dáil will have no proper input. The Government has a majority and, ultimately, it will vote with the Minister for Health and Children. It is important that the Dáil has the opportunity to serve democracy in a meaningful way and take the heat off the Minister. I urge her to consider this amendment again.

Ms Harney:  I am serving democracy, not bureaucracy. That is why I do not wish to impose huge bureaucratic conditions on the new body.

The Oireachtas will have more power under this legislation than under the current regime as the health boards are not accountable to it. Members of the health boards lost many of their powers in 1996 to the executives of the boards. The same applied to members of local authorities. There is the appearance of democracy because local authority members sit on health boards but the reality is different. The Bill will strengthen the power of the Oireachtas to hold the CEO of the Health Service Executive to account. It will require the CEO to come before this committee. I will bring forward amendments to strengthen this requirement. The Bill will require the HSE to have a parliamentary division and to respond within a reasonable timeframe to queries from Members of the Oireachtas. I will bring forward amendments to this effect. These powers are much stronger than those applying. I am giving power to the Oireachtas, not taking it away.

We must be pragmatic and sensible. We cannot have a situation where a body cannot move without this committee gathering six or seven months hence to approve its corporate plan. There are logistical issues which should be agreed, subject to ministerial approval regarding resources and so on.

Mr. Gormley: It is a question of balancing pragmatism with——

Ms Harney: Idealism.

Mr. Gormley:  It is not just idealism; it is democracy. I hope the Minister will bring forward her amendments to enable us to see what she is proposing in order that we can hold the people concerned to account. I hope we can be absolutely guaranteed that they will come before this committee.

Is the Minister guaranteeing that there will be no cutting back on the questions we can ask in the House? Is she saying that will definitely be the case?

Ms Harney: Of course but ultimately it will be for the Ceann Comhairle to decide. Within the past 24 hours someone gave me an example where the same thing had been asked in two questions and one had been ruled in and the other out. I cannot be responsible for this.

When I came into the Oireachtas in the early 1980s, the largest volume of parliamentary questions was to the Minister for Social Welfare. As a result of changes in technology and internal practices in that Department over a couple of years, Deputies do not need to submit half as many questions to the Minister because they have direct access to replies electronically or by telephone. I would like to see the HSE operate on the same basis. That is why a parliamentary affairs division would greatly assist the work of Oireachtas Members in getting information quickly, not only when the Dáil is sitting. Members of the Oireachtas should have 12 monthly access to a division which would respond to queries within a reasonable timeframe.

Mr. Gormley: I welcome that.

Dr. Cowley:   I share Deputy Gormley’s concern. The Tánaiste remarked that staffing would be the business of the HSE, not the Dáil. Everything to do with this executive is the business of the people. I am concerned that, as the Tánaiste said, the Ceann Comhairle will rule on questions. Will the information we request be kept from us, just as information on the National Roads Authority is not available to us? Will the Minister tell us she has no function in the matter? There is a real fear that the HSE will be like all the other quangos and that information on it will not be available. In Northern Ireland, for example, there are quangos in many areas. That is a real fear. The Tánaiste has not convinced me that the situation will be different from what Deputy Gormley or I have said.

Ms Harney:   Instead of Deputy Gormley having to wait for a long time to find out when a constituent will get a certain service, I hope he will get the information much more quickly under the new regime. It will take a couple of months to put this system in place. The present situation is very unsatisfactory. When a parliamentary question is submitted to the Minister for Health and Children, the Minister replies that the query must be referred to the health board. Two thirds of the questions to the Minister for Health and Children receive that answer. God only knows what happens to them after this. They take months to be answered. That will not be the position under the new regime because it is not acceptable that either patients or Members of the Oireachtas should be treated in this way.

Mr. Gormley: What will happen when we ask about waiting lists or the accident and emergency service? Will the Minister answer the question?

Ms Harney:  Questions about waiting lists will be answered by the Minister. I have ultimate responsibility and none of this will change. Deputies should not think I am plotting in order that next year they will not be able to ask the Minister any questions. That will not happen.

Deputy Gormley: I have read the document and my first question relates to the proposed arrangement with the Air Corps. Will the provision of six helicopters from the Air Corps, in terms of operating costs, amount to €24 million? The initial amount given for operating costs is €4 million. Will that money be paid to the Department of Defence?

My second question relates to a matter touched on by my colleague, Senator Henry. From my reading of the Hanly report, an issue that often arises is the transport of people over long distances. Does the delegation agree that if we are to properly implement the Hanly report the proposal today is an absolute necessity and that the Hanly report cannot be implemented without the introduction of HEMS?

Mr. O’Sullivan:  Deputy Gormley asked a question about operating costs of the Air Corps. The operating costs for the new aircraft will continue to be borne by the Air Corps. Under the service level agreement being put in place with the Department of Defence, the intention is to that there will be a nominal charge levied to the health system.

Deputy Gormley: How much will that be?

Mr. O’Sullivan: The cost for the Coast Guard is approximately €1,000 per flying hour. I think it is intended to be at around the same level.

Deputy Gormley:   So they undertake all the costs.

Mr. O’Sullivan: They charge at the marginal rate.

Deputy Gormley: I thank the delegation for coming before the committee. It is true that their presentation was extremely clear and a model for other groups.

The group’s requests are very reasonable. It is shocking to think that they are merely looking for €4.8 million over five years. In the context of the money spent on e-voting and other debacles, this is a very reasonable request and should not be refused under any circumstances. I am shocked at what Joan Bradley has told us, that 80% of people have been refused medical cards despite a specific request to the CEOs to look favourably on the issue. We need to find out why that happened.

In the aftermath of the elections, the Government may take a new course. It cannot be about market forces, it has to be about individuals and the way they are trying to lead their lives in very difficult circumstances.

Deputy Gormley:  I thank the delegation for the presentation. Ms Cahalane outlined the reasons Ireland supported this decision, but did not appear to include the fact that we were lobbied heavily in the past by the United States. Is it not well documented that Sandy Berger, for example, spoke to the Taoiseach and asked him for Ireland’s support on this issue? Surely that is also a big factor in all of this. A major question when it comes to GM field trials - it also applies to food - concerns indemnifying against possible risks. Ms Cahalane is saying this food is safe. Would the Government, the Commission or even the companies indemnify against that sort of risk? Surely that would be the test, especially given that they will not do so as regards field trials.

Where do we go from here? In Ms Cahalane’s view, is this the thin end of the wedge, now that this is coming on to the market? Can we expect to see more foods coming on to the market? What is next?

Ms Cahalane:  Yes, like tinned or frozen sweetcorn. Deputy Gormley wondered if the Government would be in a position to indemnify. This has not arisen in our discussions on food but it has been raised in connection with the crops. Our colleague from the Department of Agriculture and Food, John Downey, may be able to give us some background on what is being considered in that area.

Mr. John Downey:  One of our main areas is the co-existence of GM crops alongside conventional and organic crops and we are coming to that. The question of liability and compensation will come into play there, assuming that GM crops are approved for cultivation in Ireland. There is an inter departmental, inter-agency group set up within the Department which is considering several issues, including mechanisms of compensation and liability which will apply if there is a situation in which the cultivation of GM crops inflicted economic losses on neighbouring crops. It is based on a series of guidelines drawn up by the Commission in the context of co-existence of GM crops.

Deputy Gormley: I was asking about the long-term effects of consuming GM foods because the Food Safety Authority is saying that this is safe. If it transpired at a later stage that it led to cancer or whatever, is the authority so confident of its findings that it can indemnify?

Ms Cahalane:  : It is a good question but we base our decision on the science that is available and the advice is that this product is safe for human consumption. If any scientific advice to the contrary were to emerge, that position would change.

There are approximately 16 products on the market, mostly soya, maize and processed derivatives of those, such as oilseed rape and maize and oil from cotton seeds, most used as ingredients in processed foodstuffs. There are further approvals of GM products pending which will be put to the standing committee on the food chain and animal health, mostly also sweet corn or maize type products but also a sugar beet product.

Deputy Gormley: What about the lobbying?

Mr. Corcoran:  It may well be the case that the Taoiseach was lobbied on this issue but his Department was not in touch with us following that. If there was lobbying it did not feed into our process. It is in the nature of such issues that Departments are lobbied on all sides, whether for or against, but we were not aware of any lobbying from the United States on this issue.

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Deputy Gormley:  Is it more accurate to say it is more advantageous to big companies like Monsanto as opposed to the farmer? That is the bottom line. The vast majority of European consumers have said they are opposed to GM food, yet we, as legislators, find we are getting it regardless.

Deputy O. Mitchell: I am confused. Is the pesticide that would have been sprayed more harmful than the protein injected into the corn?

Dr. O’Mahony:  It amounts to the same thing. If one has it in the corn, only those pests eating the corn get hurt but if it is sprayed, pests minding their own business and eating weeds in the next field will also get hurt.

Chairman:  I thank the officials for an extremely comprehensive report. Do members have any recommendations they would like to include in the EU scrutiny report on this proposal?

Deputy Gormley:  We would like to reject it.

Chairman:  We can only make a recommendation.

Deputy Mulcahy:  As I understand it, the European Commission will decide on the issue next Wednesday, 19 May. We have had an interesting discussion. I believe most consumers would be alarmed about what we have heard about derivative products. We do not even know if GM levels will be less than 1%. We are eating GM food and do not know it. Derivative products will not be labelled. We should recommend that the European Commission should not introduce it. Let us write to it before 19 May and state we do not want it.

Deputy Gormley:  I second that proposal.

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Water Fluoridation: Presentation

Deputy Gormley:  I thank Professor Connett for coming before the committee. Like most members, I found his presentation helpful. I want to ask him a number of questions about the conclusions of the forum report. Would he comment on the idea of reducing to 0.7 ppm the amount of fluoride in the water? Would that have any beneficial effect on overall health? Why did they come to that conclusion? Considering the known benefits for the protection of teeth, would this change have any benefit at all?

What is the best way of measuring the level of fluoride in our bones, blood, etc.? As Professor Connett is probably aware, there have been no health studies carried out under the Health Act introduced over 40 years ago, although a section in that Act states that health studies should be carried out. In Professor Connett’s experience, have health studies been carried out in other countries to show the level of fluoride in people’s bodies? What is the best way of doing that? It is something that this committee would like to do, even among ourselves. If we, as elected representatives, could be tested for the amount of fluoride, as the Chairman has agreed to do, that would be a very valuable exercise.

I want Professor Connett to comment on the question of the fluoridation of bottled feed for babies. Has he read the transcripts forwarded to him of the committee’s questioning of the Food Safety Authority of Ireland on this matter and how they came to their conclusions? Dr. Hardy Limeback came before this committee previously and spoke strongly about fluoridated bottled feed. I thought his recommendations had been taken on board, and clearly they had been for a period by the Food Safety Authority of Ireland, but they changed their minds. I ask Professor Connett to comment on that change of mind by the Food Safety Authority of Ireland.

Professor Connett:  Let me respond as to why I think they have suggested lowering the fluoride levels. The one absolute and undeniable aspect of fluoridation and fluoride is that it causes dental fluorosis, a mottling of the enamel. This is where the whole fluoridation experiment came from. It occurred while trying to find out what caused mottling of the enamel in the United States in the early part of the 20th century. Finally in 1931 they found that the cause of this mottling in Colorado, Texas and other places was fluoride. In the process of doing that they thought they found that the children who had dental fluorosis had less tooth decay. They then wondered if they could find a level at which one could minimise tooth decay without causing too much dental fluorosis, in which case they could then add that level to the water. The optimum level that they came up with was one part per million - 1 ppm.

It was obviously a bargain in which there was both positive and negative. The negative was dental fluorosis, but they thought they could limit dental fluorosis at 1 ppm in the water to 10% of the population in its mildest form. What we find today in optimally fluoridated areas in the United States is that at least 30% of children have dental fluorosis on at least two teeth and even in non-fluoridated areas 20% of children have dental fluorosis. This clearly indicates, even by their own standards, that children are being over exposed to fluoride. Since the experiment started we are getting fluoride from many other sources, particularly from two sources. The first of these is dental products. It is very difficult to control a child’s swallowing reflex with toothpaste. The second is that once one puts it in the water, one gets it in other things such as processed foods and beverages made with fluoridated water.

While there is a limit to how much water people will drink, as the committee will be aware there is no limit to how much beer people will drink. Drinking beer is a social activity. It is not a thirst quencher; it is a social quencher.

The end result is that the York review, an English survey published in 2000, found that 48% of children had dental fluorosis in optimally fluoridated areas worldwide and 12.5% of those had it in an unacceptably visible form. The figures in Ireland are similar. They have admitted the end point of dental fluorosis and claimed that one could lower the fluoride intake further and still get protection against tooth decay. It is stated in the report that one needs at least 0.8 ppm to protect teeth but this is now being lowered to 0.7 ppm, which is an inconsistency. It is a compromise, a half measure, a way of giving in to the opposition to fluoridation in order that it will give a little. The dental establishment in Ireland is unwilling to admit that it was wrong, that times have changed. It was a different age when fluoridation started. We had great confidence in all types of chemicals to do all kinds of wonderful things such as DDT, PCBs, asbestos and lead in gasoline, all of which have gone by the wayside, except the one substance called fluorine.

The second issue is what we should be measuring. The simplest thing to measure is the fluoride level in urine because that will tell what one’s daily dose of fluoride is, which is about half of what is being ingested. If one measures the fluoride level in urine and multiplies by two, one will have an idea of the total fluoride intake. Up to 50% of all the fluoride we ingest each day accumulates in our bones. It is not what fluoride does in one day, one week, one month or even one year but its effects on one’s bones over a lifetime.

The earliest symptoms of fluoride poisoning of the bones are identical to arthritis. One in three Americans has arthritis and we do not know what causes it in many forms. If one asks one’s doctor the causes of arthritis, he or she will say he or she does not know but it may be related to ageing. What is happening in the ageing process is the steady accumulation of fluoride in our bones. If one gets more than this, the bones become brittle. That is the concern about increased hip fractures, of which the epidemiological studies are mixed. There is no question but that it accumulates in our bones.