Seán Crowe (Dublin South West, Sinn Fein)

The Government amendment to this motion is an insult. It does not address any of the specific issues raised in the motion, for which I congratulate the Technical Group. The Government has failed to address the serious safety issues raised by the Health and Safety Authority. As the motion states, the Health and Safety Authority has called for an urgent safety inspection of all accident and emergency units. That is a damning indictment of the management of the health services by the Government.

The Tánaiste and Minister for Health and Children did not address these safety issues in her contribution. However, the Minister stated: "People will judge our health services by accident and emergency services." I have news for the Minister — they have already made that judgment on the basis of nearly eight years of this Government. One would think to listen to the Tánaiste that the Government was only elected last October following the reshuffle and that the two previous Ministers for Health and Children were not members of the Government. What happened to collective Cabinet responsibility for health between 1997 and 2004?

The Government published a health strategy in 2001. Much of it remains on the shelf unimplemented. A cornerstone of that strategy is supposed to be primary care — improving GP services and establishing GP co-ops, out of hours services and primary care centres. These primary care services are not being delivered and, as a result, people still go to accident and emergency units with ailments that should and could be dealt with by local GPs or health centres.

Why are so many still going to accident and emergency units in this way? It is because many who do not qualify for the medical card because their income is above the threshold cannot afford the high GP fees being charged. All this increases the pressure on accident and emergency units.

Anyone who believes the current Minister and her party will bring equality to our health services is living in cloud cuckoo land. An ESRI study has shown that the richest fifth of the population in the State has the highest access to hospital specialists. News of the opening of the first private accident and emergency unit in Galway has been welcomed. However, I do not welcome a situation where public accident and emergency units are in crisis while people are facilitated to make massive profits from private health facilities with privileged access for wealthy people.

The Minister will tell us that the State can now buy services for public patients in private facilities. However, everyone knows that the State will end up paying over the odds for these services in order to make profits for the private owners. This will only reinforce the obscene two-tier system where wealth buys health in this State.

Last year I asked the Minister for Health and Children about the numbers left on trolleys at Tallaght Hospital during the last Dáil session and the length of time before these patients accessed wards in the hospital. The question was referred to the Eastern Regional Health Authority but the figures I received from the authority contradict the figures in the media at the time, as well as contradicting figures I recently received from the Irish Nurses Organisation. There is a difficulty in that the ERHA states its figures are accurate while other outside interests and interests within the hospitals state that there seems to be a problem with the figures.

For example, on 1 October 2004 some 13 patients were on trolleys at Tallaght Hospital. The previous day the figure was 23, 33 the day before that and 39 and 32 on the previous two days. However, I was told by the ERHA that only 14 people were on trolleys at the end of that week. The previous week, that ending 29 September 2004, some daily figures for patients on trolleys were 23, 36, 46 and 51. However, the ERHA figure for the end of that week was 26. For the week ending 17 September 2004, some of the daily figures were 29, 27, 25 and 35 on 13 September. However, the figure from the ERHA is for 12 patients on trolleys at the end of that week. The figures do not add up.

I visited a number of patients, including my brother in law, in Tallaght Hospital last week. Everyone I spoke to there had a story to tell about the situation in the accident and emergency unit. They had nothing but praise for the hospital staff — doctors, nurses and so on. However, from talking to people in the wards, I got a sense of what was happening in the hospital that week. I met one man who had a heart problem, although he was in the hospital for another complaint. He spoke about the difficulties he encountered: it took him days before he got a trolley. In addition, he had left home without his heart medication. He was supposed to be treated in the hospital for another complaint but no heart medication was provided for him during his period in A&E. He eventually received the heart medication but when he was transferred to a bed, the medication was somehow lost within the system. I wonder how many people have had that experience.

If a person is on medication, because of the bedlam in the hospital, no one seems to be checking that every patient has their required medication. That appears to be an additional difficulty within the hospital system.

We talk about the indignity of lying on trolleys but I came across another man who had a serious bowel complaint. In many instances the public toilet facilities were not available so he had the constant worry of whether he would make it to the toilet in time.

There was a woman there whom I know very well. She has a problem with her kidneys, has lost a leg and is blind in one eye. She had a problem getting off the trolley to try to get to the toilet. Patients were helping other patients in such circumstances. The nurses brought her nearer to the nursing station but the problem was that because they were so busy the woman was occasionally left unattended. That indignity added to the worry and trauma she and her family experienced.

I came across another patient and for some reason her husband was administering her medication, as were the hospital staff. While she was in the hospital, she complained of suffering from a constant headache but it was probably due to the fact that she was being over-medicated. Such cases demonstrate the difficulties that are occurring in Tallaght Hospital.

One woman there vomited into a cardboard carton which was left there until the next day. No one cleaned it up.

During this period a number of elderly people were there, along with younger people who came in with drug addiction problems. At one stage there was an elderly person at one end of the A&E unit and three people who were clearly on drugs. The situation was chaotic to say the least and bad language was being used. In such instances elderly people are left in a situation which deprives them of their dignity.

Another woman in the hospital was extremely upset because she could not receive holy communion. Apparently those attending A&E cannot receive that sacrament, which is a problem. I realise that matter cannot be sorted out by the Minister of State but it is an additional difficulty encountered by people who are left in A&E units. It adds to the worry and trauma they experience.

The majority of people in Tallaght Hospital have nothing but praise for its services but the system is collapsing around them. There is clearly a need for greater investment. There is also a problem with regard to the lack of beds. Those responsible for the situation in the hospital, that is, the chief executive officer, the hospital authorities, the health board and the Department, are not working off the proper figures. How can the problem there be solved? People are saying that difficulties arise because we are into the winter period and matters will get worse before they get better.

The Minister may say that the Government will be judged on what is happening in A&E units but clearly the situation is deteriorating. Whatever measures the Minister seems to have initiated do not seem to be reflected in what is occurring on the ground.

Callers to a recent edition of the Joe Duffy radio programme referred to a lack of pillows in hospitals. Millions of euro have been spent on the health service, yet a hospital can still run out of pillows. Another difficulty concerned patients' need for water. Clearly, if people are walking up and down, there is nowhere to put a jug of water. Another simple problem is that there is nowhere for patients to put their valuables. In one case, during that week, someone's valuables went missing.

People are going into hospital sick, yet we are adding to their indignity. In most of the cases I came across, people were referred to the hospital by their GP. They were not trying to avoid going to their local doctor. The last place they wanted to go to was the hospital but their experiences there were extremely bad. I have nothing but praise for the hospital staff, including doctors, but the system is crumbling around them.

This motion is positive and I do not think the Government's amendment addresses the problems to which I have referred. Hopefully, however, we will begin to see some changes in the system. The cases I have cited constitute one example of my experience of one hospital but I am sure those difficulties are being replicated around the country.

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