Willie Penrose (Longford-Westmeath, Labour) | Oireachtas source

I understand RTE intends to cease broadcasting the "Fáilte Isteach" programme, which has special resonance for elderly people and Irish people abroad. Is this not another sign that the national broadcaster will up sticks at the first opportunity and an illustration of a view in RTE that the culchies are alright and do not matter because they are outside the Pale? If it cared to check, it would find that people outside the Pale also pay the television licence fee of €160. It is time to acknowledge Irish music of all genres and commission dedicated programmes to allow it to take its rightful place in this country. We had such programmes in the 1960s. What is wrong with Irish music now? Is it a case of turning up our noses because it is Irish?

I have listened with great care over the years to the well-rehearsed mantra repeated across the health service that money will follow the patient. This policy, we were told, would deliver benefits such as better outcomes, greater throughput and output, more efficiency and effectiveness, improved case-mix and shorter turnaround periods. As far as I can determine, this objective has been binned in respect of the Midland Regional Hospital in Mullingar, which in recent years has catered for a significantly increased level of activity with a noticeable decrease in its budget allocation. The hospital provides very good care for patients not only from its natural hinterland of counties Longford and Westmeath, but also from County Roscommon to the west and counties Meath, Offaly and Kildare to the east, without any additional allocation being made available to accommodate its additional workload.

If the policy of having money follow the patient is to have any meaning, the Health Service Executive should match its sugary words with deeds. We need only consider the wrangle in the past six weeks when a firm commitment by the HSE to have 35 additional staff appointed to the Midland Regional Hospital in Mullingar started to unravel only a short period after it was given. Ten midwives, ten emergency department nurses and 15 other staff were to be placed across hospital wards where pressure had been clearly identified. More than 560 patients spent time on trolleys in March, which is the second worst record in the country after St. Vincent's Hospital in Dublin. The number of patients on trolleys was 125% higher in March 2015 than in March 2014. People in Mullingar want all the recommendations of the emergency department task force report implemented without any side-stepping or obfuscation. Acute beds which have been closed since as far back as the previous Fianna Fáil-Green Party Government must be reopened. On average, seven babies are born each day at the Midland Regional Hospital in Mullingar. It is vital, therefore, that the additional nurses promised for maternity services are appointed.

The health service nationwide will need additional resources. These must be complemented by a significant improvement in outcomes and a change in work practices to permit X-ray machines, PET and MRI scanners and all other radiological equipment to be utilised on a 24 hour basis.

The Midland Regional Hospital is part of the Dublin east hospital group. The aim of the hospital is to deliver a quality-driven, people-centred service to the population of the Dublin east and midlands region, in particular the Longford-Westmeath area. The hospital has 204 beds and provides the following services: accident and emergency; radiology; general medicine; general surgery; obstetrics and gynaecology; paediatrics; pathology; dermatology; and outpatient services, including ophthalmology. It also provides diagnostic radiological and pathology services; physiotherapy; occupational therapy; speech and language therapy; cardiac diagnostic and rehabilitation services; pulmonary function services; laboratory services; and respiratory services.

The out-of-hours general practitioner service, MIDOC, was relocated to the hospital in September 2014 and is accommodated in the outpatient department. In 2014, the hospital had 21,594 inpatient discharges, with an average length of stay of 3.17 days and dealt with 8,276 day case procedures. Some 2,796 deliveries and 32,859 emergency department attendances were recorded. Expenditure in 2014 was €61.43 million, while the allocated budget for 2015 is only €57.9 million. One does not need to be a mathematician to work out that the hospital will have a major deficit this year.

The hospital has a number of key areas for development. A design team has been appointed to develop a project consisting of operating theatres and associated developments as a single build project consisting of a new operating theatre department with a dedicated obstetric theatre; a new endoscopy department; a new combined critical care unit; a rehabilitation ward; and a therapies department for physiotherapy, occupational therapy, speech and language therapy and treatment facilities. It is also planned to update the current hospital development control plan to allow for further expansion of facilities in the years ahead. In addition, work has commenced on remodelling and upgrading the emergency department. I hope this important project will be completed by the end of the first quarter of 2016.

The hospital has highlighted the need for an MRl scanner as it currently shares a scanner with Tullamore and Portlaoise hospitals. This scanner, which is based in Tullamore, is operated through a public private partnership arrangement. One machine cannot cope with demand from a population of nearly 250,000. Members of the community are willing to raise funds towards the cost of providing a new scanner. I ask the HSE to provide co-funding for this equipment.

Provision must be made for the appointment of a consultant geriatrician at the Midland Regional Hospital in Mullingar and the establishment of a community and elderly care liaison team for the Longford-Westmeath area. Other requirements include the development of an in-reach and outreach service to nursing homes, the development of an ambulatory care assessment unit for older people using the day hospital model, step-up care beds and domiciliary visits other than nursing homes in the local hospital area, with a clinical case manager role for older people, and support for the education of staff in nursing homes. Much remains to be done.

The unemployment rate has fallen below 10% and 90,000 new jobs have been created. It is important that a sustained effort is made to ensure the benefits of employment growth are not confined to large urban areas but are spread nationwide, especially to rural areas. As an advocate for the midlands, I raise again the continuing failure by the IDA to get some industry to locate in the industrial park in Marlinstown, Mullingar. This is an ideally located site housing two major indigenous manufacturing industries which are doing extremely well. Notwithstanding the many positive features associated with the site, its location and the town of Mullingar, which has excellent facilities, efforts to attract foreign direct investment have been fruitless to date.

In the context of the policy shift by IDA Ireland where the midlands is now subject to a special focus of its development team to highlight the region's attractiveness and suitability, has Mullingar been elevated to the priority status which it deserves for such a campaign? It is the least the people of Mullingar and the wider north-east region deserve rather than copious platitudes and voluminous words. While the ultimate decision as to where a company locates resides with the company itself, I hope IDA Ireland will redouble its efforts in this regard.

Much of the debate on the statement focused on taxation and multinational enterprises. While multinationals account for a large proportion of our exports, the sector only employs a small share of the workforce. Up to 90% of Irish-owned firms are small and medium-sized enterprises, and 69% of private sector workers work in SMEs. Since 2008, employment in SMEs fell much more than it did in the multinational sector. Future employment growth depends on SMEs. Despite a great deal of rhetoric about the importance of the self-employed and the SMEs, some of the provisions of the economic statement were detrimental to the sector.

There is no justification for the 11% universal social charge rate imposed on the self-employed, particularly as they are not entitled to the same level of benefits as those on lower USC rates. Given the outrage over the low corporation tax paid by Apple and other multinational companies, it is worth noting the 11% USC rate paid by the self-employed earning more than €100,000 is the same as the percentage of tax paid on profits by the multinationals. Unlike the multinationals, the self-employed person pays a 40% marginal income tax rate in addition to PRSI contributions. What is the justification for a marginal rate of income tax of 55% for the self-employed while PAYE workers pay a marginal rate of 52%?

It could be argued that because of the level of insecurity and risk the self-employed must endure, they should pay a lower marginal rate than those in secure employment. Some left-wing politicians and commentators seem to think that the entire self-employed community is well-off. Some, however, take home little more than what they would earn on the minimum wage. It is very inequitable that tax credits given to PAYE workers are not available to the self-employed and low earners. Despite this rhetoric we hear from the Government claiming it is supporting the self-employed and those setting up small businesses, the income tax system discriminates shamefully against the self-employed. A self-employed worker earning €15,000, half the average industrial wage, will pay 14.9% of tax on that income while his or her counterpart in the public service will only pay 1.9% of the same sum. The self-employed person will pay €2,235 while the PAYE worker will pay only €285. The self-employed person will be entitled to fewer benefits despite his or her large tax contribution.

After the collapse of the building industry in 2008, many self-employed builders found themselves almost destitute. Despite having paid substantial sums in income tax, they found in some cases they were eligible only for a means-tested supplementary welfare allowance. Due to the way the building industry is organised, many building workers are forced into self-employment and, while earning no more than PAYE workers, they are entitled to fewer benefits. Far from being a path to riches, being self-employed or establishing a small business is often a high-risk activity with little return.

One of the most misleading figures quoted about Irish industry is that it is the most profitable in the EU. When the multinationals are removed from the picture, Irish firms are among the least profitable in the EU, coming third from the bottom after Lithuania and France. While employers’ PRSI is low in Ireland, other business costs, such as energy and professional services, are among the highest. It is important risk-takers are rewarded. The Government must address some of the inequities identified in these areas. The divide in this area is growing. We are going to depend on self-employment. We have to look at pension provision in this area too. I am aware of the issues in this regard having been employed and self-employed. The self-employed must pay for everything, be it a licence or whatever. This comes out of a non-existent profit and one’s overdraft. Banks are now cutting out overdrafts.

Coming from a small rural area, I know there are many protests about the closure of services in such areas. I am not joining any more of these protests, however. While Government policy can contribute to this, the very people who close these services are the people themselves. There are facilities there which they should use.

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