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

I welcome the opportunity to address these matters to the Minister and to the director general of the HSE in this, the commencement week of the resumed Dáil.

The figures from the INMO trolley count for today, 15 January 2015, were provided to me before the commencement of the meeting. The Minister referred to a trolley count of 244, but he failed to also mention that there were 72 further positions created on the wards, which creates an overcrowding situation, and these are not appropriate placements. The total is 316 as of the commencement our meeting.

This is not about trying to portray the Minister or the HSE in a negative light, as the Minister referred to in his opening remarks. It is about people. It is about patients in inappropriate circumstances, on trolleys and chairs, who are not at their best. We must recognise that the situation is outrageous.

On the figures provided by the INMO, I understand that, as happened under the tenure of the Minister's predecessor, these will now be officially accepted figures. We used see a tug of war between one set of figures and another, almost on a daily basis. I hope the Minister is not challenging what the INMO presents here as the factual position applying across each of these hospital sites.

Whatever the Minister's view on the INMO, whatever his view on the voices that he will hear today, what about what Mr. Tony O'Brien stated here this morning? In his presentation, Mr. O'Brien stated clearly that this was neither a new nor an unaccepted situation. He is telling it exactly as it is. He went on to state that due to reduced budgets over the past number of years, the required capacity, particularly in our community services, just simply is not there. He also stated that there was insufficient capital funding available and that there was insufficient funding in the capital plan to bring the required infrastructure to the required standard. Those are not merely messages for the committee. Those are messages for all of us in political life, be it in government or in opposition. It is critically important that Deputy Varadkar, as Minister, listen to and heed what Mr. O'Brien put on the record here this morning. Mr. O'Brien is not defending the indefensible and he is not ignoring the problem; nor is the HSE. The fact of the matter is they are strapped and they need, to repeat what has already been said, a re-evaluation of the resourcing.

On the language used, it is clearly the case that there is great disappointment within the HSE at senior management level. Mr. O'Brien stated that the Minister had managed to secure a total of €25 million. Perhaps Mr. O'Brien or any other representative here might shed light on it. Is it not the case that €106.5 million was properly and scientifically determined as the amount needed in order to avert the problem that has now presented? Why is it that in this instance we are only looking at €25 million, which quite clearly will not be able to address the problem as it must?

I ask the Minister what immediate steps were agreed at the second meeting of the emergency department task force yesterday. What immediate steps are now to be taken to ensure that there is the bed capacity and the required number of nursing staff? It is important to emphasise the Minister cannot keep introducing beds while working with the current complement of nursing staff on the front line. It just is not physically possible. What steps are now to be taken to ensure that there is an immediate recruitment effort? I refer not only to advertising for qualified nurses to return here from the neighbouring island and other settings, but to whether any consideration is being given to the significant number of former nursing staff who took early retirement options presented by the HSE and who live in the communities the length and breadth of the country, who are properly qualified, and who have the energy and wherewithal to step in at a moment's notice where an emergency presents. Is any consideration given to looking at them as even an interim position pending an effective recruitment campaign? I believe there is merit in examining that. I know personally some of those who would willingly step forward. If there are impediments or obstacles because of the circumstances of their departure under the offered early retirement packages, the Minister should overcome those problems, because the far greater problem is the need of those who, as we speak, are in inappropriate settings in the hospital emergency departments and on wards at hospital sites throughout the country. Will the Minister outline the immediate steps that will be taken in terms of localised recruitment and how he will ensure the speedy movement towards recruitment for the 265 nursing posts currently marked as vacant? Will he recognise that we cannot go forward with an increasingly elderly population with 5,000 fewer nurses than there were prior to 2008?

Public residential care beds are a key component, as Mr. O'Brien stated. He continued by saying that they must be retained at existing levels despite the impending issues with compliance and infrastructure. I agree. We all want to see the infrastructural needs addressed and the highest standards laid down by the Health Information and Quality Authority, HIQA, introduced, employed and sustained into the future. However, we are continuing to reduce the public residential care bed capacity across the country. My home county has only one such facility. Due to the need to meet HIQA's determinations, welcome works have been undertaken, but with a reduced capacity. This is not acceptable. There is a total contradiction. We will meet HIQA's requirements while blinkering ourselves to the facts that we have an ever-increasing ageing population and we will provide fewer beds. It is long past time that the alarm bells were heard. We need to act together. I take no pleasure in taking a run at the Minister on any of these issues. Far better would it be were I able to work with him and ensure that, together, we delivered a health system that was fit for purpose and of which we could be proud. There is no room for pride in respect of our health services today.