Clare Daly (Dublin North, Socialist Party)

I will share time with Deputies Joan Collins, Mick Wallace, Luke 'Ming' Flanagan and Mattie McGrath.

We heard comments from the Government yesterday and today to the effect that reform takes time and that there is a bit of a disconnect due to the changeover, but that basically the Government is heading in the right direction and dealing with the issues. The comments suggest those of us on this side of the House do not know what we are talking about and have nothing to offer. The Government side should have read the motion. It clearly states the Government should stop doing what it is doing and do the opposite. It should reverse the cutbacks and invest in a publicly funded health service.

We are not making this up. We are articulating the views of those at the coalface, the staff and patients who must, on a daily basis, deal with the crisis in our health service. Yesterday and on a number of other occasions, the Minister referred in a positive light to Tallaght. I would like to focus on the situation in Tallaght. It has the biggest catchment area of the five major Dublin hospitals and caters for a population of 500,000 people. If one hospital in Africa had to cater for that many people, we would probably take up a collection for it. Last year, accident and emergency attendance at Tallaght Hospital was 93,000 people, in comparison with 60,000 at its nearest rival, Beaumont Hospital. Tallaght Hospital had just short of 250,000 outpatient attendances as opposed to the Mater, which was the next highest at 202,000. However, Tallaght Hospital has the lowest number of consultants and is significantly below the average number of beds for the top five Dublin hospitals.

What is the reward for the hospital which sees the most patients, with the least number of doctors? Not under the watch of Fianna Fáil, but under the watch of the Minister for Health, the reward this year has been a slashing of the Tallaght Hospital budget, down to €175 million. That is almost €30 million less than the next lowest amount for one of these hospitals. The Minister told us yesterday that this was all right, because the number of people on trolleys in Tallaght Hospital is okay and the hospital is operating within its budget. He is wrong on both counts. Tallaght Hospital is not within budget, but is operating on an overrun of over €10 million so far. There are not fewer people on trolleys there either. Let us debunk this myth now. What has changed is the method of calculation. HIQA has told the hospital only to count people on trolleys within the confines of the emergency department. How has this been sorted out? It has not been sorted out by the addition of beds or by dealing with people. It has been sorted by pushing trolleys out of the emergency department and putting them in wards where people are still sitting on trolleys and chairs but are no longer counted in the statistics. This is nauseating.

The Minister said that he is also dealing with the issue of primary health care and that we cannot just focus on hospitals. That is right. We need to address the issue of primary health care urgently. However, the Minister is not doing that. He talks about doing it, but he is not doing it. Again, Tallaght is a good example. There, the lack of GP coverage is a key problem which feeds into the crisis in the hospital. With a population of 71,000 there are only 24 GPs in the area, one per 3,000 people. Yet, the HSE and the Minister have a facility outside the gates of Tallaght Hospital. This is Chambers House and it was supposed to be a primary care unit. Some €3.5 million was put into that house, but the Minister told the Tallaght Hospital action group in June that it will not now be the primary care unit because it is unsuitable and the doctors would not go into it. Instead, it will be used for other community purposes. To add to this debacle, over €2 million has been spent on the old TB hospital at Crooksling to provide a convalescent facility, but the Minister is not facilitating this to release beds in Tallaght Hospital and is shutting it down.

We are going backwards and at the rate the Minister is going, we will not stop until we are almost back to the poor laws and the workhouses. I do not say this lightly, but what is in front of us is the elimination of public hospital cover and care, due to the creeping privatisation which is actively facilitated by Fine Gael without a whiff of abstentionism from the Labour Party. The Minister's universal health insurance scheme is a back door drive towards privatisation. It means privatisation and profits for the big companies and a lesser service for ordinary people. The solution for which we have constantly argued is a properly funded single tier public health service, along the lines of the NHS before it was butchered and progressively dismantled, where health care is a right and not a privilege for the few.

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