James Breen (Clare, Independent)

Our hospitals are slowly suffocating to death due to neglect and lack of investment, as is the case with Ennis General Hospital, where staff have been working under protest since 8 a.m. on Thursday, 20 January 2005. This protest was fuelled by the failure of senior management to respond to the issues of poor staffing levels. Ennis General Hospital is one of the busiest in the regions, with increased activity in the area. Workers will continue to work under protest until the shortages have been addressed.

We would all welcome a holistic health model that would meet all our aspirations in terms of what we expect from a health service and which is also cost effective. Why is so much emphasis put on expenditure and financial limits when at all the affected hospitals we should be prioritising this problem and introducing positive initiatives to ease the discomfort of patients and the excessive workload on nursing and other frontline staff? The Government and hospital management must take primary responsibility for the reality that the problem is getting worse. We should seek to minimise the extent of overcrowding and acknowledge the discomfort and distress experienced by patients in the nights and mornings when they find themselves spending extended periods on trolleys. Further investment should be made to increase bed capacity with the employment of additional nursing and other support staff to deal with the extra workload.

We have a national crisis and the experience of recent days confirms this. Much more can be done at hospital level to alleviate the suffering of hundreds of patients and the intolerable workload on nursing staff with as many as 400 patients on trolleys in accident and emergency departments awaiting beds at various times. The recurring problem of overcrowding in accident and emergency units is posing a serious risk to patients. The problem is much worse in a number of Dublin hospitals, with 46 patients on trolleys at Tallaght Hospital, 28 at St. Vincent's Hospital and a further 28 at the Mater Hospital.

Our health service is fragmented, disparate and disjointed. Accountability for the service is dissipated. Information is either non-existent or difficult to access. The Government hoards money for this mishmash while allowing the underlying problems to fester, leaving a service that is coming apart at the seams and screaming for reform.

As a result of a better health service we will live longer but there will be higher maintenance costs associated with keeping sick people alive and optimising their well-being. There must be a system to ensure that we know exactly where the money is needed and how it should be spent. Too much has been wasted in the health service because of a lack of basic information — the underestimation of the extension of the medical card to those over 70 by millions of euro is one such example. Our health service cannot afford these mistakes. There is an urgent need for significant investment in information technology.

Patients need the comfort, certainty and reassurance of being able to see a doctor. People living in urban, suburban and rural communities need to be reassured that the distance they live from a hospital will not influence the reaction in an emergency. To avoid these problems we should have the things we were promised — better equipment, more ambulances and fully trained staff. People want a form of medical cover on a 24 hour basis, and it is not beyond the ingenuity of the Government to provide it.

The hundreds of millions of euro for upgrading general hospitals and their services have not been matched by spending on long-term care centres or community services which are vitally needed. Even with subvention, private nursing home care is not an option for many people. The publicly funded long-term care we offer these people is often distant from their homes and families, which can cause great distress for patients and relatives at a difficult time.

The public is becoming more aware about the health system; it is continually under the microscope and health will be a priority in the next election. The Minister must ensure that the immediate needs of the thousands awaiting treatment and the shortage of staff are addressed. When will the €20 million promised four years ago by the then Minister for Health and Children, Deputy Martin, be spent on upgrading Ennis General Hospital?

I am deeply concerned about the failure of the Tánaiste and Minister for Health and Children to make any impact on the ongoing crisis in the accident and emergency departments of our hospitals. I demand that she should address this problem, outline a time-scale for action to tackle the growing sense of frustration among staff in accident and emergency units, make urgent provision for sufficient new beds and assist the hospitals to meet all the needs arising from the risk assessment by the Health and Safety Authority.

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