Billy Kelleher (Cork North Central, Fianna Fail)

I move:

That Dáil Éireann:

— recognising that since 1997 life expectancy has risen by 5.3 years for men to 78.7 years, and 4.5 years for women to 83.2 years;

— confirming that between 1997 and 2011 major advances in tackling cancer were achieved with survival rates being improved dramatically and that death rates from cardiovascular disease had fallen massively;

— acknowledging that there were more than 170,000 patients treated by the National Treatment Purchase Fund (NTPF) up to 2010 and waiting times had been reduced;

— further acknowledging that the World Health Organisation ranked Ireland 19th in the world for its health system in 2010, ahead of countries like Germany, Belgium, Switzerland and Sweden;

— calls on the Government to immediately put proper governance structures in place in the Health Service Executive (HSE);

— condemns the €750 million in cuts to the health service contained in the HSE's National Service Plan 2012 for its detrimental effect on patient safety and front-line services as already detailed in the HSE South and HSE Dublin North East Regional Plans, and expected in the other regional plans;

— denounces closures to acute hospital beds and operating theatres as outlined in the Regional Service Plans;

— condemns the Government for:

— failing to halt increasing medical card waiting times, particularly where the entitlement to the card is not in question, which directly hits the sick, the old and the most vulnerable people; and

— introducing the insurance levy and extra costs to the health insurance industry which has directly resulted in people paying up to and over 50% more for their plans, causing them to leave the private system, and resulting in extra pressures on the public system;

— denies that front-line services are being protected or patient safety guaranteed, particularly when the CEO of the HSE has admitted that the critical impediment to the safe delivery of services in 2012 is the availability of adequate numbers of appropriate staff;

— confirms that the implementation of the early retirement scheme, which will result in 4,200 staff leaving at the end of this month, has been mishandled and is causing anxiety to patients and their families;

— calls on the Government to publish their contingency plans, inclusive of any proposed bed closures, to manage the outflow of front-line staff, especially acute, midwifery, 211 and community services staff such as home help staff;

— calls on the Government to lift the recruitment embargo for critical front-line posts particularly in the clinical area;

— condemns the announced closure of Community Nursing Hospitals in Abbeyleix and Shaen in Laois, and Crooksling in Dublin, especially given the distress caused to patients and their families, and calls on the Government to halt plans to close other community nursing hospitals which will remove 898 beds from the public system;

— calls on the Government to ensure adequate funding is provided this year to fund the fair deal scheme;

— condemns the Government for its decision to close the 24-hour Accident and Emergency Department in Roscommon Hospital and for breaking its election promises to keep it open;

— calls for the NTPF to be reinstated fully and separately from the special delivery unit so that waiting times and numbers of patients being treated can be accurately and transparently measured;

— opposes the introduction of reconstituted not-for-profit hospital trusts given their potential to reduce funding to smaller hospitals; and

— rejects the Minister for Health, Deputy James Reilly's plans for universal health insurance given it will massively increase costs to the Exchequer and to families, and that there is no evidence that it would improve outcomes.

I wish to share time with my colleagues.

I welcome the opportunity to speak on this motion. It gives us an opportunity not only to discuss broader health issues but to analyse the policies of the Government and the commitments made in the run up to last year's general election and to assess what has flowed from them in terms of output and policy. Any perusal of the facts suggests that there have been many failings in the delivery of services. When one considers what was said this time last year and where we are now a year on, it is clear that some of the policies held up as being the answer to the major difficulties facing us in the delivery of health care, are failing and failing very rapidly.

The Minister held up the special delivery unit as a central plank of his policy for dealing with waiting lists. Any analysis of that unit suggests it is failing rapidly when one considers the number of people waiting for day procedures and inpatient procedures. The number has climbed to more than 60,000 for people who have been on waiting lists for more than six months. Clearly, there is a difficulty.

When one analyses the Minister's quotes and commentary when in Opposition on the protection of front-line services and the capacity of hospitals and emergency medicine to deal with inpatient and outpatient procedures, it is clear that if there is a reduction in capacity, there is a corresponding increase in the number of people on waiting lists and in the time that it takes to deal with procedures for people. The special delivery unit is not functioning as outlined.

Another issue has been the raiding of the National Treatment Purchase Fund. That fund was an effective way of dealing with waiting lists. Some 170,000 procedures were carried out under it. That fund was getting to grips with reducing the waiting lists that had existed for some time. Any analysis of that fund in recent years would show that we were getting on top of that issue. We now find that the special delivery unit, since its inception last July, is beginning to run out of steam. Even the recent figures, as shown by the HSE, indicate that as time passes, the number of people on waiting lists for six months and more will increase dramatically if the current trends continue. The special delivery unit was established to deal with the number of people waiting to be treated on trolleys in accident and emergency departments. Some 420 people are waiting to be treated on trolleys on 21 February 2012. That is an indication that the special delivery unit is not functioning as outlined.

A broader issue is the responsibility with which the special delivery unit has been charged. This issue has been raised on a few occasions. We have to get to the bottom of it in terms of the base figure of people who were on waiting lists for more than 12 months and the disparity between the HSE and the Department of Health and the special delivery unit in the numbers and the base guideline that was outlined by the Minister in the House recently . There is quite definitely a discrepancy in the original number of people on waiting lists. The Minister said yesterday that the reason there was an increase in the number of people on waiting lists was that he had been dealing with people who have been on waiting lists for 12 months or more and that they were the priority. That does not explain why there is now more than 60,000 people who have been on waiting lists for six months or more when we spoke about a few hundred people on waiting lists for 12 months or more. We need to get clarity on this. There is a smokescreen exercise here with regard to the figures and number of people who were originally waiting 12 months or more and what the special delivery unit has achieved to date.

Ms Sara Burke exposed the fact that Dr. Martin Connor, the Minister's key adviser, spends a considerable amount of time out of this country. He is the Minister's four star general and he is on a salary of €160,000. I am not questioning his ability or capability when dealing with issues but the Minister would be apoplectic with rage if the previous Minister announced that her top adviser was not in the country on a full-time basis dealing with the serious issue of waiting lists. That issue is a cental tenet of the Minister's policy. We need to get clarity on the amount of time Dr. Connor spends in the country and, more importantly, what the special delivery unit is now charged with in terms of waiting lists because to date it seems to be failing quite rapidly.

Another issue is the waiting times to process medical card applications. The medical card application system was centralised. The need for coherency to be brought to bear on the way in which medical card applications are analysed was raised on a few occasions last June or July. Unfortunately, appalling cases have been raised by Deputies, day in and day out, and even by members of the medical profession. Some doctors in the north east are withdrawing their service and support because they are so concerned about the chaos in the application system for medical cards. This issue was raised at the Committee of Public Accounts last week and clarity was provided in the context of the number of people waiting for processing of medical card applications and renewal applications. It is unacceptable. There is a policy deep down in the Department of Health, of which the Minister is the head, to slow down the processing of medical card applications as a money-saving exercise. People who are terminally ill are waiting for their medical card to be renewed for months on end. That is unacceptable.

The Minister will be aware of a case I brought to the attention of the House last week. It is unacceptable that a person who is terminally ill was asked for further medical evidence.

See this speech in context