Peadar Tóibín (Meath West, Aontú) | Oireachtas source

Gabhaim buíochas leis an Taoiseach agus lena fhoireann as teacht isteach agus as a chur i láthair.

I will focus on two different areas but I am not saying any of this in a combative fashion. I genuinely say it in an effort to tease out some of the problems that exist in government at the moment. If one looks at housing, healthcare, the cost-of-living crisis or the migration issue, there seems to be a big problem with competency at the heart of this Government. The Government is very able in many ways in trying to bat away allegations of bureaucratic inertia in housing and health and so forth but given all of the key performance indicators in all of these areas, a man of the Taoiseach's intelligence would have to admit, even secretly, that the level of progress is minimal. In fact, the Government is going backwards in many of these areas at the moment.

If we look at the healthcare system, we have record waiting lists for operations and record waiting times in accident and emergency departments. We had 120,000 people on trolleys last year, many of whom were old and infirm. Thousands of people waited for more than 24 hours on a trolley to get treatment. In 2021, we had 105,000 adverse incidents in the health service. In other words, the health service damaged 105,000 people through some manner of ill treatment, mistakes and so forth. The State paid €2 billion in negligence payments over a period of five years. Negligence payments are made because people physically suffered due to adverse incidents in the health service and that cost is being met by taxpayers. That is money that should have been invested in the health service.

Even today I am getting texts from the hospital in Navan to say that 39 patients were triaged last night but are still waiting to see a doctor. That is not even counting the people who are outside in the waiting room who have not yet been triaged. We have this incredible situation - I do not know if it is an intellectual fashion in the HSE - whereby even though we have a population that is increasing and getting older, the belief is that we should close more accident and emergency departments. On top of that we have an ambulance by-pass of Navan coming in, leading to Drogheda becoming a car park for ambulances. Ambulances are waiting for five hours to deposit their patients which means there are no ambulances available for Cavan, Monaghan, Louth and Meath. This is happening at a time when figures indicate that ambulances are less likely to meet their targets for getting to patients with serious illnesses within a specified time. It seems that decisions in the health service are eternally being made against the flow of evidence.

If all of this was happening during a funding crisis, at a time when there was a lack of money, people would be able to say there is very little we can do but we are spending more money on the health service than ever before. Ireland has the biggest proportion of its national budget being spent on the health service. Is there not an absolute crisis of competency at the heart of the running of the health service?

The Taoiseach:Míle buíochas, a Theachta. It will not surprise the Deputy when I say I do not agree with him but it is a reasonable question to ask. I remember President Biden once saying "Don't compare me to the Almighty, compare me to the alternative". If the Deputy wants to see how we are performing as a country, he should not compare us to perfect but to other jurisdictions. He should look to other countries around the world and see how they are performing. There are nearly 200 countries in the world and they are all grappling with different problems and often those problems are very similar to ours.

To deal with health, which is what the Deputy focused on, we are seeing waiting times, that is, the length of time people have to wait to see a consultant or to get an operation, soaring around the world. North of the Border, in the NHS and all across Europe we are seeing the same problem, unfortunately, because of increased populations, ageing populations, new treatments and, of course, the disruption of the pandemic. In Ireland, we are seeing some improvements. As I mentioned in my initial statement, waiting lists as we measure them fell by 11% last year and we are looking for a further 10% fall this year. To explain that measurement, in the Sláintecare report, on an all-party basis, we agreed that nobody should wait more than ten weeks if they need to see consultant and no more than 12 weeks if they need an operation and the numbers waiting longer than that fell in 2022. We are determined to make sure they fall again in 2023. There will always be people, as I am sure the Deputy will acknowledge, who are waiting five, six or ten weeks but we want to make sure that nobody is waiting more than that. That number fell in 2022 and we believe it will fall again in 2023.

In terms of patient outcomes, we have one of the best life expectancies in Europe. I think it is the highest in the EU now, but I might be wrong about that. That is not because we have such wonderfully healthy lifestyles in Ireland, that we barely drink or smoke and we all get a lot of exercise - far from it. The main reason is that our health service delivers very good outcomes, which is largely down to the quality of our front-line staff. Outcomes for stroke, heart attack and cancer are improving and are way better now than the outcomes in the NHS, which some people think is an example we should follow. Why would we follow an example that has worse outcomes for cancer, stroke and heart attack patients, lower life expectancy and all of those patient outcomes that the Deputy mentioned?

Do not get me wrong - I do not want to downplay for one second the problems that we have in our health service, particularly in emergency departments. I have been in every single one in the country, probably more than once, and have worked in four of them. I am horrified at the fact that patients have to spend hours and hours on a trolley waiting for admission to a hospital bed. It is one thing if that happens for a few hours or if patients are in a cubicle but I know that patients waiting on trolleys in corridors for more than six or eight hours results in reduced patient outcomes. We know that from research from western Australia, America and the UK. That is a profound problem that we have been struggling to get on top of for a very long time.

There is one thing that the Deputy and I agree on - I do not think that closing emergency department is the solution. I do not think an emergency department in Ireland has been closed in ten years. No emergency department closed when I was Taoiseach or Tánaiste. As far as I remember, the last time was when the department in St. Colmcille's hospital closed and that was part of an agreement between Wexford and St. Vincent's hospital and it has worked reasonably well. It did not work very well in the mid-west and we are still trying to build up University Hospital Limerick, UHL, so that it works better and to make better use of the other hospitals in the region. The Deputy has heard me speak about that previously.

In Navan specifically, the change in the ambulance protocol makes sense, whereby ambulances are taking critically ill patients to bigger hospitals where they can get better care. I would not like to see the emergency department in Navan closed and certainly not before the other hospitals in the region are significantly upgraded. I know that if it was closed, it would have a very negative impact on Connolly Hospital, which is my local hospital and on Our Lady of Lourdes Hospital in Drogheda. That is why the Government has resisted proposals to shut it down all together.

I will make one final comment on negligence. I do not believe that Irish doctors, midwives, nurses, and scientists are any more negligent than their counterparts in any other part of the world. Mistakes happen in healthcare. The vast majority of the cases the Deputy mentioned were settled but they were settled without an acknowledgement of liability or negligence and it is important to say that. We have fabulous doctors, nurses, midwives and scientists and the fact that a case is settled is not an admission of negligence.