Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

I thank the Deputy for raising the issue. In terms of lifespan generally, the last 20 or 30 years have seen a dramatic improvements in lifespan. Over the history of the State, we have gained 25 years in lifespan. In terms of health outcomes, there have been fairly dramatic improved outcomes on cancer care and survival rates and cardiovascular in terms of survival from cardiac issues. Heart disease was a huge killer in Ireland. It still remains a killer, but less so than it would have heretofore been. Stroke has been dramatically improved. The outcomes from stroke now are much better and it is all about early intervention. If one looks at the area of pre-ambulance emergency care, the professionalisation of that has been transformative over 20 years. Sometimes when we talk about health spending - it is exponentially growing - we also have to acknowledge that in a lot of areas there have been a lot of good outcomes because of that investment.

The focus on the emergency departments and the overcrowding is valid in regard to whether we are getting the outcomes that we should be getting by now in terms of the investment, both in human resources and in physical capacity. We have to add the population growth, which is a significant factor which was probably under provided for in some respects over a period, because we have gone from 3.5 million people in the 1990s to 5.2 million today and in the last two years alone the population has significantly increased for a variety of reasons. That is set to continue in Ireland because historically the population was probably lower than it should have been if one looks back to the Famine period and right through. The population growth is a key factor.

On University Hospital Limerick, the trolleys are down 20% compared to 2019 but that is not enough. The outpatient list is down 30%. There are an additional 730 staff, 100 additional beds and 200 more under construction. There is a surgical hub on the way. However, we need reform as well. The seven-day week roster idea is important in terms of getting better use of the asset that a hospital represents, and out of the equipment and the facilities, etc., and getting better value for money, get more productivity and get greater volumes done.

With all the investment, the volume of activity is increasing all of the time as well. That gets lost in all of the figures. To be fair to the health service, sometimes we do not give recognition of the fact that the extra spending has meant extra activity, operations and diagnostics. We have to continue to invest in community and primary care to take the pressure off the acute service and make sure people get the right care, at the time and in the right and most appropriate location.

See this speech in context