Séamus Healy (Tipperary South, Workers and Unemployed Action Group) | Oireachtas source

I welcome the HSE staff to this meeting. Mr. O'Brien has outlined the figures fairly clearly and we see there has been a reduction of €3.3 billion or 22% in the health budget in recent years. Approximately 10,000 staff have left the health service already. This year there will be a further cut of €721 million to the budget and a net reduction, if I am correct, of around 3,000 staff. That budget is unrealistic and I would be very surprised to find that it is achievable. Cuts of this magnitude are effectively undermining the delivery of health services in this country, particularly to people who are ill and require treatment urgently.

Small hospitals were mentioned in Mr. O'Brien's report and I ask him to clarify exactly what he means by small hospitals. Are there identified small hospitals and, if so, could he name them for the committee? Mr. O'Brien referred to a target of a maximum waiting time of 52 weeks for outpatient appointments.

Perhaps Mr. O'Brien will outline how it is proposed to achieve this, particularly given that in the south east the waiting time for an orthopaedic appointment classified as urgent is 18 months and for non-urgent appointments it is three years. There is a significant waiting list for orthopaedic appointments, as in respect of other specialties, at Waterford Regional Hospital. How is it proposed to reduce these waiting lists to 52 weeks in the current year?

On income, I note that legislative change will be required. How soon is it expected and will it come soon enough to meet the targets set in the plan? On medical cards, in my view there is a continuing difficulty in this area, particularly in respect of medical cards sought on grounds of long-term ill-health. Perhaps the delegates will outline how it is proposed to address these difficulties, in particular in respect of medical card applications by very ill people. In my experience, there are significant delays in processing medical card applications. We have been told that for a person to obtain a medical card urgently his or her GP would have to indicate that he or she is terminally ill, which is a difficult situation in which to place any applicant, his or spouse or representative. What is the structure of the process by which cards are granted on medical grounds? For example, how many doctors are involved in this scheme, what is the timescale for processing applications and can the delegates give a commitment that this process will be streamlined and expedited particularly for people who are very ill?

On medical card income limits, it is my understanding that these have not been increased since January 2006. I would welcome a response from the delegations on that issue also. Last year - it may have been the year prior to that - the Minister announced that those who qualified under the long-term illness scheme would as of right receive a medical card. At what stage is this process and how soon in the delegates' view will it be implemented? Also, was this scheme impacted financially by the recent budget?

As I have previously stated, the manner in which the HSE does its business, in particular in terms of decision-making which affect patients in my area, is, in my view, unacceptable. There is no consultation with staff, patients or stakeholders prior to decisions being made. Last week, a decision was made and announced by the HSE to transfer a rehabilitation unit from St. Patrick's Hospital in Cashel without any consultation with patients, staff or stakeholders. This practice must change. If the HSE does not introduce such change, the Minister must then introduce legislation which will entitle stakeholders, including staff and patients, to be consulted prior to decisions being made.