Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I thank the Chair, I echo his views and remarks and I acknowledge the benefits of North-South co-operation. Such co-operation is equally beneficial to patients on both sides of the Border. Everyone benefits from it. I offer my congratulations to all involved.

I congratulate the Minister on the delivery of health services over the past two or three very trying years. In what were very difficult circumstances, doctors, nurses and other front-line workers, as well as those in the back line, worked way above and beyond the call of duty in order to maintain services and ensure that the best decisions were taken, in quick time, to protect the health of our community and, as a result, that of our economy. All of those involved can take a bow. While the health service comes in for a lot of criticism, some of it warranted from time to time, it must be acknowledged that a huge job of work was done without demur and that continues. Long may that be the case.

I want to refer to a couple of points the Minister made. He referred to the fact that the delivery of services had not necessary kept step with the significant increases in resources. That has to be the intention and the target into the future. Every effort has to be made to ensure that is seen and recognised by everybody. We spend a lot of time in this House, and elsewhere, criticising the health service. None of us is above criticism and no sector is above criticism. We must endeavour, in so far as we can, to meet those criticisms, whether warranted or not, and deal with them.

The Minister referred to CAMHS. This service, which was the poor relation for many years, has gotten even poorer but that cannot follow. We cannot continue down that road. We need to bring that service up-to-date rapidly and make sure that patients have a safe place to go to receive the appropriate treatment. They should not have to wait an extraordinary length of time for a diagnosis, report, follow-up or the services they cannot access, for reasons we cannot always understand. It is a priority that be done forthwith.

I congratulate those behind the initiative and experiment taking place in Naas whereby the primary care centre has taken over responsibility, on a pilot basis, for carrying out minor operations and dealing with sprains and other minor things that can be effectively dealt with in the community care centre. I saw such an initiative in Northern Ireland 20 or 30 years ago. Primary care centres were able to engage with patients and deal with them in the same way as they would be dealt with in a hospital emergency department. They could do so more quickly and there was no negative impact on the accident and emergency department. That experiment should be looked at carefully to see how it works and, if possible, it should be replicated as quickly as possible.

I recently mentioned in the House the fact that I have, in another capacity, had need to visit two, three or four accident and emergency departments in recent times. What I saw was not ideal from the point of view of the public health services. In particular, I refer to the attitude of some patients who are regular attendees at accident and emergency departments towards staff. They were extremely abusive and used threatening language and gestures. At all times, they engaged in appalling and foul-mouthed abuse. That is not supposed to go on in our accident and emergency services. There are people who go there for attention because they are ill or worried, many of whom have never been in an accident and emergency department before, and who are intimidated by this nonsense. I saw fights break out. People wielding crutches who had already been admitted to the hospital came back out to the emergency department to indulge in warfare. That kind of thing just cannot go on and cannot continue. No accident and emergency department anywhere can be run that way. Staff cannot be expected to put up with that kind of nonsense. First, it is a distraction and, second, it is intimidating. If there are people who are out of their minds with drugs, drink or whatever it is, they should by all means be attended to, but it should not happen in the same accident and emergency department. There should be a different place down the corridor so that they know where to go and do not intimidate other people who have an urgent need to attend a hospital accident and emergency department and who need an early diagnosis. I ask that particular attention be given to that aspect or facility of our health services at the earliest possible time.

The health service, the HSE and the Minister have been criticised lately for a stall, slowdown or pause in recruitment. There has been significant recruitment and a very great increase in personnel in the past 12 months. That is to be welcomed. We need to welcome and acknowledge it where it happens and record our appreciation. It is not all bad news. It might be the thing to do to spread bad news. Maybe it is part of our culture. Maybe we love that kind of thing. However, we have to acknowledge the work that is being done, the basis on which it is being done and the people who do it in difficult and trying circumstances. That is the first general part. Perhaps I could have some replies or responses to that.