Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank Ms Magahy and her team for all of their work and for the very comprehensive presentation, including all of the facts and figures.

Different people mean different things or hear different things but, essentially, Sláintecare is universal healthcare, which involves three components, namely, access, quality and affordability. One has to be able to get care when one needs it, it has to be high-quality in nature and it has to be at a price that does not cause a person undue financial hardship. Unfortunately, we are moving rapidly in the opposite direction. Access within the public health system is collapsing. We have the worst level of access ever in the history of the State and we have by far the worst access to healthcare anywhere in the developed world. It was getting better quite quickly but over the past five or six years, it has been growing rapidly worse. Over the past three or four years, the decline has accelerated. I fear that we have passed a tipping point whereby some of the negative feedback loops are reinforcing the damage already done. Word has got out within the clinical community globally that Ireland may not be a great place to come and work as a doctor, nurse or midwife for reasons relating to working conditions, etc. These things reinforce themselves.

Ms Magahy has a very good, attractive-looking slide in her presentation that illustrates the different parts of the system. I made a few notes as I went through it. In my area of Wicklow, mental health services pretty much do not exist. I have no doubt that it is the same in many other areas. They are now telling people that they are not even going to bother putting them on a waiting list because the service just does not exist any more. Self-care in the advanced medical sense of having diagnostics and working with GP-led teams to manage one's own care also does not really exists. Dentistry services exist but they are too expensive for most people to access in any meaningful way. For the first time ever, in many instances it now takes several weeks to see a GP. A group of pensioners in Wicklow town recently told me that if they call their GP regarding, for example, respiratory issues that need to be seen to immediately or the person could end up in the accident and emergency department, it can be three weeks before they are seen. GP care has never been as hard to access. That is if one can access it. A new patient cannot actually get a GP pretty much anywhere in Wicklow any longer. Occupational therapy appointments may take four years if one is a really severe case. For a child to get access to speech and language appointments, it can be three, four or five years before he or she is seen. In fact, they are beginning to send out letters now saying that it will be at least two years and that a time cannot be given because there is no money, resources or therapists. This is the reality faced by children, mums and dads.

If one gets to a hospital, to St. Vincent's, for example, there could be a wait of a few days on a trolley. A person would be lucky to get a bed. People are terrified of having to go into accident and emergency departments. Diagnostics have reached the point where people are just trying to borrow money to pay for private appointments because they are being told it could be six months, a year or two years before they can get the scans their doctors think they need. If a person gets a scan and is referred for specialist care, it might be another year or two before he or she gets to see that doctor. If that doctor says that an operation is required it could be another year or two years before that is done. This is the reality. Social workers in Wicklow have so few resources they are working out of their cars.