Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

My party has tabled an amendment because the motion in the name of the Fianna Fáil Deputies does not go far enough either in its analysis of the causes of the crisis in our public health services or in the measures it proposes. Last week, the Minister for Health, Deputy James Reilly, told us that 4,200 staff members will have left the public health services by the end of this month. That is higher than previous estimates and, despite all the assurances of the Minister, the Taoiseach and their colleagues, including the Minister of State who is in the Chamber this evening, Deputy Kathleen Lynch, there is no public confidence that contingencies are in place to fill the gaps that will appear in the health services, perhaps not immediately on 1 March but very soon thereafter. The Government has repeatedly tried to portray this exodus from the health services as simply a matter of people taking early retirement. It omits to mention that the recruitment moratorium remains in place and, as such, most positions will not be refilled and existing staff will have to fill the gaps in services. Front line services will be thrown into deeper crisis. That is the inescapable reality that will present.

This is all part and parcel of the contraction of health services under the austerity regime begun by the Fianna Fáil-Green Party Government and continued by the Fine Gael-Labour Party coalition. The Fianna Fáil Party motion rightly condemns the €750 million in cuts from the health service budget for 2012 but conveniently ignores the €1.5 billion taken out in 2010 and 2011 under the previous Administration. That is one of the contradictions in the motion. The assaults on our public health services arise directly from the toxic policy which all three parties share, Fianna Fáil, Fine Gael and the Labour Party. They are truly the austerity parties of Ireland.

Since we had Dáil statements on the Health Service Executive's national service plan, we have seen the publication of the plan for the Dublin-north east region and the western area. The former is shocking in the extent of the cuts it imposes on public health services in the region. Expenditure reductions of €120.55 million are to be achieved in 2012 on top of the funding reduction of €493.5 million imposed between 2009 and the end of 2011. This region covers north Dublin city and county as well as counties Cavan, Monaghan, Louth and Meath. The plan reveals that the region will see 400 staff retiring at the end of February. What is hugely worrying is that in addition to this, up to 561 more staff will "need to leave the service" this year.

The Minister failed to respond to the point I made at Question Time last week that this additional reduction amounts to a very serious further diminution of staff. If the situation was not already bad enough in terms of what was flagged up by the early retirement exodus, we now have a clear statement of intent on the part of the HSE in the Dublin-north east region that an additional 560 staff members will "need to leave" in the course of 2012. I asked the Minister to acknowledge that the departure of 961 health service staff within one region will have devastating consequences for service delivery and for patient safety. His response was to accuse me and my party of scare-mongering. That is crass in the extreme.

This exodus of staff will indeed be a devastating blow to health services across the board. It is not what I want to see and I take no relish whatsoever in having to address these facts. The plan further states that these massive staff reductions will be needed "before any priority replacement staff are recruited". That tells us very definitely that key front line service staff in the Dublin-north east region will not be replaced. Staff will not be recruited to cover these essential areas until such time as the significant staff exodus, including the 561, is completed. That is what is stated in the report.

We are threatened with 100 bed closures in acute hospitals across the region and 105 long-term care bed closures. Some €71.3 million is being slashed from the hospitals budget. There will be cuts of €10 million in primary care, including cuts to out-of-hours GP services; €7.5 million from older people services, including reduced home help hours; €12.6 million from disability services, including 534 fewer respite nights; €7.92 million from children and family services; €2 million from social inclusion services; and €500,000 from palliative care. These cuts come directly in the wake of reductions already imposed in January, including outpatient clinic reductions on the back of the deficits carried forward from 2011.

The HSE west regional service plan was also published last week. It proposes to slash public health services across the board in the largest of the HSE regions geographically, which stretches from south Limerick to north Donegal and from north Leitrim to Connemara. Patient care will be hit hard in a region that has experienced some of the worst of the health cuts of recent years, with reductions of €104.8 million set out for 2012 . The plan reveals that the west will see 683 staff retiring by the end of February, with further job cuts to be imposed before the end of the year. There are major cuts across all key services. The loss of 132 long-term beds will be a blow to the care of older people, as will the threatened closure of care homes.

One direct result of this is the ending of residential care at Lifford hospital. As my colleague, Deputy Pearse Doherty, stated, this Government, like its Fianna Fáil Party predecessor, has ignored the people of County Donegal who took to the streets in their thousands demanding that community hospitals remain open and that health services be cut no further. When speaking at a Fine Gael rally in Stranorlar in June 2010, the then Fine Gael spokesperson on health, Deputy James Reilly, pledged support for Lifford and other community hospitals. He said: "Certainly Lifford will not be closing, that's for sure. It's far too important and serves far too big an area." These are the words of the now Minister for Health, Deputy Reilly, who a few moments ago occupied the seat now occupied by Minister of State, Deputy Lynch.

The cuts in service plans as presented are set to close hundreds of nursing home beds and an as yet unknown number of nursing homes. We are facing a year of terrible cuts and a crisis such as we have never experienced before. It challenges me to understand the effort employed during the early to middle months of last year in terms of the recruitment of essential non-consultant hospital doctors in order to stave off the crisis that would present as of 1 July when, with the exodus of 4,200 by the end of this month, there is no sign whatsoever of any foreboding in terms of the difficulties that will present for front line service providers. All of this was well signalled for some considerable time. The Minister for Health, Deputy Reilly, must accept that we are careening headlong towards the mother of all crises in our health services. He is in the driving seat. It is time he applied the breaks and took corrective action. I urge him, and all voices that can bring influence on him, to do so. It is in all our interests and those we represent. I urge Deputies of all opinion to support the Sinn Féin amendment.

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