Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I always welcome an opportunity to address the Minister on these matters, which I acknowledge are of mutual concern. However, he must accept that these are bizarre circumstances for us to meet and address these matters. We are meeting within a week of budget day against a backdrop of unprecedented cuts in recent years. I refer in particular to the removal of €1 billion in 2011, €750 million in the current year and cuts of a further €130 million announced at the end of August. The impact of all of that is the backdrop to today's meeting, but it is compounded by the recent announcement of a Supplementary Estimate for the remainder of the current year on which we have yet to hear the detail. That is a major deficiency in terms of the address of all the difficulties that present.

I welcome the Minister's statement in his address this morning that the current health system is deeply flawed. He said it is unfair to patients and often fails to meet their needs fast enough and fails to give value for money. In arguing consistently against many of the cuts that have been imposed, it is not for a moment to suggest that there are not greater efficiencies and better value for money measures that could be employed.

In his opening paragraph the Minister stated, "in order that everyone is aware of the difficulties we face". He will appreciate that in our role as Opposition voices, but more particularly as Dáil Deputies the greater part of our engagement is with people directly on the ground, whereas for the Minister the equilibrium changes due to the other issues and demands on his time. It is a two-way street. I heard all that has been said but we must also share with the Minister the reality of the impact of the cuts that have been imposed and the fact that on the penultimate occasion when he appeared before us in committee he signalled some €900 million in further cuts in the health budget in 2013. That was the figure he confirmed.

There are areas that must be revisited. I make no apology for highlighting the serious impact of the further cuts imposed on home help hours and home care packages. That is the smallest part of the €130 million cuts announced by the Minister at the end of August. I earnestly appeal to him on the issue. I have ample evidence from replies received to parliamentary questions. I know the Minister does not draft the replies. He probably rarely, if ever, sees the questions we pose but I will cite a couple of examples from my constituency. The home help hours of a 94-year old man have been halved from eleven hours a week to five hours. Yesterday, I received a reply to a parliamentary question about a 99-year old man in County Mayo whose three hours a week were reduced to two hours, and without any assessment of needs. The information was communicated by telephone. My County Cork colleague, Deputy Sandra McLellan, told me of a woman aged 82 who lives alone. She suffered clots on her lung earlier this year and requires oxygen on a 24-hour basis, takes medication for her breathing twice a day and is also on warfarin. She had one hour of home help four mornings per week and a half hour in the evening and also two night visits per week to help with oxygen. Her morning home help visits are being cut by 15 minutes per day and the night time visits have been cut altogether.

I instanced the situation because I re-emphasise again the importance of it. The Minister made the point, "in order that everyone is aware of the difficulties we face". We are aware and we acknowledge them. These are not happy times but as I have said, it is a two-way street. We must also to inform the Minister. It is part of our function and responsibility to communicate the direct consequences of the decisions that are taken and how they impact on the lives of the people that we all represent. We endeavour to do our best in that regard.

This morning the Irish Nurses and Midwives Organisation, INMO, will launch the report of its recent survey of comparisons on staffing within the acute hospital system with what applies in the neighbouring island. The results are alarming. The report indicates a significantly lower staffing level for surgical, medical, accident and emergency services and elderly care. The consequences of all of that, as outlined in the report, is that lower nurse staffing is associated with higher mortality, other adverse events and poor care, less effective and efficient care and higher fatigue and burn-out among the professionals providing those services within the hospital network. We all know that is the case. We meet those nurses, midwives and the other front-line care professionals on a weekly basis. The Minister must be mindful of all of that. I strongly urge that he ensures that every effort is employed to resist any further cuts across the health services.