Paul Gogarty (Dublin Mid West, Green Party)

I did not get too many injuries, thank God. My excuse was that they had Packie Bonner in goal and that is why we lost. Deputy Eamon Ryan got a bit of a knock. It reminds me of a football analogy concerning the health service. A couple of years ago, someone's stud went into my toe and a bruise developed. Of course, being a man, I left the injury untreated for a couple of days by which time it had become swollen. Eventually, I decided it was time to attend St. James's Hospital. I went there at around 8 o'clock in the evening. At 5 o'clock the next morning the nurse came to have a look at my toe. She heated a paper-clip under a Bunsen burner and then put the red-hot paper-clip through my toenail. All the pus spewed out and the swelling went down. It is not rocket science, which is the point I am making. Why should that procedure have to be done in the accident and emergency unit of a major Dublin hospital? Why could it not be done by a GP on 24-hour call in a local community? There are plenty of opportunities for that sort of service.

The Green Party has long been calling for a three-tier health service with primary care receiving the major share of investment, where appropriate. An example would be in Lucan and Clondalkin, both of which are areas of large population. They should have their own 24-hour clinic. We have already seen newspaper articles reporting that some consultants are refusing to see people who are inebriated in A&E units. That is because such people are taking up valuable time for treating others with real health problems. Alcoholism is a major problem in our society, as is excessive drinking amongst all age groups, but there is a more appropriate place to deal with drink-related problems than in accident and emergency units.

If there was a 24-hour clinic with a doctor and nurse on call in densely populated areas, most of the problems currently facing A&E units could be dealt with at local level. People can be referred to hospital if necessary but there is no point in trying to crack a nut with a sledge-hammer — or, indeed, crack a toenail with a paper-clip — in an A&E unit. That is my message to the Tánaiste, although she is not in the Chamber. There are ways of saving money that do not entail diminishing the health service. What is needed is an appropriate level of service and care. St. Loman's Hospital in my constituency is located half-way between Lucan and Palmerstown and lands there were recently sold for more than €30 million. That some of the funding is going towards community care, in keeping with the ethos of St. Loman's Hospital, is welcome. However, it is not known where the rest of the money will go. I propose setting up a local 24-hour clinic in the vicinity to serve Lucan, Palmerstown and north Clondalkin. That would do more to reduce queues at Tallaght Hospital, St. James's Hospital and James Connolly Memorial Hospital than any amount of money thrown down the drain. The Government took approximately 3,000 beds out of the system and is talking about putting 3,000 beds back into the system. That could be a long way down the road. We need to examine creative ways of sorting out the problem immediately. An obvious way would be to have more respect for overseas doctors and nurses who come here.

Lucan is rapidly becoming the Nigerian capital of Ireland. I recently met a group of Nigerians who are setting up a branch of the largest Nigerian political party. Approximately half of the group who met in the Mansion House were nurses who work in the health care service. They were brought here because we did not have enough nurses. Until recently they had problems in that their partners were not allowed to work here. They are also having problems in getting their children in. They want their children to be educated and to spend time with their families. It is not an unreasonable request. However, barriers are created by the Department of Justice, Equality and Law Reform at every opportunity. The same applies to a Pakistani couple I know. The husband is a doctor. The wife is a doctor who has been rearing children for a number of years and must do training to get back into the system. However, when they wanted to hire someone who could speak their native language to look after the children, it took much bureaucratic wrangling to get such a person into the country. We have also heard about the flight of Filipino nurses to other countries because of the way they have been treated here.

These situations need to be addressed. If they are not we will have no health care staff here, let alone a diminished but very hard-working crew. Part of the reason for that is that Irish nurses, who for many years went to Australia, the Far East or the Middle East for a year, are staying in those places for a number of years and some are not coming back here but are going to England to work. The reason is that pay and conditions for nursing staff here are not sufficient. Rather than forking out money to pay for staff from other countries, we might be better off using it to pay Irish staff to stay in Ireland. That is something the Minister could also consider.

I have another example of cost efficiency within the health care service which, again, relates to football, in this case a charity game in Navan. A colleague of mine from the Lucan area broke his leg while playing in a match. He was brought to Navan Hospital where he was X-rayed and was told that for a proper X-ray he would have to go to Drogheda hospital. This needs to be investigated and if no one else will raise it, I will. The software for the communications system within the health care service is seriously flawed. Otherwise the man's details could have been taken and forwarded them to Tallaght Hospital. I will not name names, but it was fortunate that the person in question knew someone in Tallaght Hospital who knew of a cancellation and was able to get him transferred for the X-ray and operation in Tallaght Hospital. Otherwise he would not have had to travel to Drogheda for ongoing treatment.

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