Joan Burton (Dublin West, Labour) | Oireachtas source

I want to raise an issue I have raised with both the Minister and the Taoiseach on a number of occasions, that is, the question of the section 39 hospice organisations. As he will be aware, hospitals recruit on a particular basis. Hospital staff of various grades have been the beneficiaries of the pay restoration, which was initiated when I was in government. However, the hospices recruit exactly the same staff for whom there is a lot of back and forth between hospitals and hospices. It is a good experience having that happen but it means that from the beginning of January, hospices had to pay the increase without any reimbursement from the Government of the cost of the increase. The annual cost of the increase currently for the hospices involved in Cork, Limerick and Donegal, St. Francis Hospice, Raheny and a number of other hospices, is €1.126 million. The retrospective element is estimated at just under €1 million.

The Minister's presentation indicates that he is approaching the forthcoming budget in the knowledge that there are significant flows of moneys into the Exchequer and while we have a total mess in housing and health, nonetheless, he will meet his targets. He has gone on the record publicly, as has the Taoiseach, in appreciation of the valuable work hospices do. All of us know through relatives and personal experiences among our broader families and friends that dying in a hospice in Ireland from a serious illness is a different experience from being in a busy general hospital with screens around the bed. The Minister has expressed his support and sympathy for the hospices on a number of occasions. In the context of a relatively small amount in this case, I cannot understand the reason he failed to act. Nobody can understand the reason the Minister for Health is unable to influence the runaway budget in his Department. It is usually the case that part of a Minister's job is to meet the budgetary targets; that is what they commit to try to do. All Ministers have difficulties but this has been brought to an art form in the Department of Health. We have a situation where the money is pouring in but, partly because of demographics and other reasons, the deficit is growing. I do not believe the Minister denied that it is possible the deficit this year could be in excess of €800 million, and that it might even reach €1 billion; the Taoiseach indicated the same to me. Why would the Minister single out the hospices for the kind of treatment he and his Taoiseach have decided on?

Also, in practical terms, given my ministerial experience and my own professional experience, the hospices have developed an in-hospital service where hospice staff go into busy general hospitals to try to help patients, and the hospital, when they are approaching end-of-life. That has been a good service. They have a service level agreement for that with the HSE. The service is saving costs for the HSE, which is not functioning optimally, to put it mildly, yet those who took the cuts, which are documented cannot get the Minister and the Taoiseach to agree to a restoration process. The Minister has been sent the documentation. In the context of a dysfunctional health service meeting any of its budgetary targets, I wish he could explain that.