Beverley Flynn (Mayo, Independent)

I also welcome the opportunity to speak during this important debate on the health services.

I accept that the number of hospital beds has increased by 1,200 since 2001. While the number of beds in acute hospitals in County Mayo has increased by 60, there has been a greater reduction in the number of beds available in public long-stay facilities, unfortunately. That reduction has contributed significantly to the problems which have been encountered in the accident and emergency department of Mayo General Hospital over recent years. The Government made a commitment in recent times to develop community nursing homes so people can be looked after within the community. Some of those who served with me on the former Western Health Board will be familiar with the campaign, which has been ongoing for over 20 years, to develop a community nursing home in Ballinrobe. Now that a site is available, all we need is a commitment from the Government to spend the money that is needed to ensure the proposed community nursing home becomes a reality. Such a development would make a significant difference in that community. I ask the Minister of State, Deputy Seán Power, to contact the HSE to ascertain the current status of the proposed development in the list of priorities. The nursing home should have been built and opened in the Ballinrobe community long before now.

I do not think all the contract beds which are available in my local area are being utilised. The provision whereby beds can be contracted out to nursing homes is not being availed of. I do not know whether the hospital authorities are trying to save money for other areas within the hospital budget. This matter should be examined because there is plenty of availability in many private nursing homes in the area.

Like many of my colleagues, I have made the case over many years for a fairer subvention rate to be made available to older people in the west. I have pointed out that there is a significant gap between the subventions paid in the western and eastern regions. While there has been an increase in the rate over recent times, there continues to be a gap of over €400 between what one receives as a subvention in County Mayo and what one receives on the east coast. We will not accept minor increases if we are expected to think they will solve the problem. The discrimination that has existed in respect of subventions — the fact they have been so low in the west — has meant many people who would have liked to take up beds in private nursing homes have been denied the right to do so.

I welcome the increase in home care packages over recent years. Just five packages were awarded in my local area in 2005, at a time when the home care package system did not represent a realistic option for older people who want to live in their own homes, which is something the Government supports. I welcome the significant improvements in that regard over the last year.

I would like to speak about the transport of people by ambulance to hospitals. I am concerned about the limits on the availability of ambulances to bring people to hospitals in my local area. County Mayo is a huge geographical mass — it has a diameter of 140 miles — with some very remote areas. Many people in the county, who rely on social welfare payments, do not have the money to pay for taxis to bring them to visit people in hospital. Perhaps we should demonstrate a little more leniency in the provision of transport to and from hospitals

I support the Minister's position on consultants' contracts. I agree with the proposals to provide for public-only contracts; to arrange for the provision of services by consultants 24 hours a day, seven days a week; and to move from a service that is led by consultants to a service that is provided by consultants. I commend the Minister on the manner in which she is pushing that agenda. Mayo General Hospital has been waiting for a number of years for a rheumatology consultant to be appointed. People who are in severe pain have to travel to Galway. Some of them have been waiting for seven years or more to be seen by a consultant. I brought this matter to the attention of Professor Brendan Drumm at a meeting of the Joint Committee on Health and Children and I am bringing it to the attention of the Minister of State now. I understood that funding would be provided in 2007 to alleviate this problem, but it does not appear at this stage that it will happen. I am particularly disappointed about that. I ask that something be done about this matter, which is a priority in the Mayo area.

I would like to mention the plight of nurses, who have balloted for strike action, in the context of the debate on consultants' contracts. I supported a motion on this matter at a meeting of the Joint Committee on Health and Children. I agree that nurses should get a fairer deal in our hospitals. I support their call for a shorter working week, for example. The Labour Court indicated 26 years ago that the working week of nurses should be reduced from 39 hours on a phased basis. This proposal should be considered by the Government. Hospital administrators have a 33-hour working week, whereas nurses have a 39-hour working week. Nurses who complete four years of education as part of the degree course should receive fairer pay. We are discussing consultants but we should not forget nurses, who are the backbone of the health service. I ask the House to support their claim.

I acknowledge the work that has been done on medical cards. There has been a significant increase in the number of people who qualify for medical cards. It is noticeable that many more people have been getting medical cards over the last two years, in particular. I welcome the considerable improvements which have resulted in recent months from the changes to the guidelines for GP cards, because by November 2004 we had witnessed a situation over the previous few years whereby many people had lost their entitlement to a medical card.

I also support the investment of money by the Minister for Health and Children and her Department in primary care teams, which constitute an essential component of health service reform. I look forward to the Government meeting its commitment to increase the number of primary care teams throughout the country over the next number of years, so that there will be 300 such teams by 2008, 400 by 2009 and 500 by 2011. This component of the health system will be of great assistance in our communities in the years to come. I ask the Minister of State to bring the points I have made to the attention of the Minister.

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