Jan O'Sullivan (Limerick East, Labour)

The Minister of State at the Department of Health and Children, Deputy Devins, referred to statistics which indicate high levels of satisfaction with health professionals. I agree that members of the public are satisfied with the high standards of service delivery across the health sector. However, staff morale is being significantly weakened by the use of the blunt instrument of cutting services across the board.

I do not propose to discuss individual examples but we have specific and definite information concerning cuts to frontline services in hospitals in Sligo, Clonmel, Ennis, Tullamore, Galway, Limerick and elsewhere. In addition, expensive equipment in hospitals will not be used to capacity because overtime will not be provided for staff who could use the equipment in acute cancer services and other areas. Cutting frontline services and prohibiting the recruitment of additional staff is a crude instrument.

The House has not received an answer to a question raised by many Members, including some Government backbench Deputies, as to what will happen to patients in hospitals where cancer services are cut immediately. No information has been provided on how these patients will be accommodated in the proposed centres of excellence. I fully support the centres of excellence concept but we need to know what will happen to the patients in question and how they will be treated. I presume, for example, that a general surgeon who currently performs a certain number of breast cancer interventions in a hospital that is set to lose its cancer service will remain in his or her current post. In such circumstances, how will the breast cancer service he or she provided continue to be delivered. From where will the necessary resources come?

Deputies Clune and Flynn referred to cuts in paramedic services, including physiotherapy, occupational therapy and speech therapy. These cuts will badly affect those who rely on these services, many of whom are on waiting lists. The latest cohort of dieticians, another occupational group in this category, will graduate in the coming weeks. As the recruitment freeze will still apply, they will have no alternative but to emigrate in search of work because none of them will be employed in the health service here. Generally, graduates find temporary positions and are eventually appointed to permanent positions. The recruitment freeze raises a strong possibility of a brain drain of expensively trained health professionals.

The "HSE Watch" section on the Labour Party's website features a comment from a physiotherapist who was due to take up a permanent physiotherapy post in Dublin in the next few weeks. Having given notice, the person faces unemployment due to the recruitment freeze and is seriously considering a career abroad, never to return "to these medieval medical services". There is a real danger that health professionals will leave the country and possibly not return.

In my previous portfolio as the education spokesperson of the Labour Party, one of the issues we discussed was the need to train more physiotherapists, dieticians, occupational therapists and speech therapists. A degree of success has been achieved in this regard through undergraduate, postgraduate and nursing programmes. However, if we create circumstances in which these trained professionals see no alternative but to move abroad to work, we will undo some of the good and expensive work invested in building up the professional base in the health service.

MS Ireland has stated that physiotherapy, respite care and home help cuts will be inflicted on people with neurological illnesses. The result will be a reduction in frontline services to the most vulnerable people.

According to an RTE report today, there are 41,400 people on waiting lists. The figure includes 12,000 adults who have been waiting for more than six months and 2,200 children who have been waiting for more than three months. These figures directly contravene a commitment in the health strategy to ensure that, by the end of 2003, no adult would have to wait longer than six months and no child longer than three months for treatment. The HSE's strategy of imposing a recruitment freeze, therefore, has a direct effect on Government policy. The Minister and the Government cannot wash their hands of this issue because it affects Government policy on the reduction of waiting lists. The Minister may assert that there is no proof that a cut in frontline services leads to increased waiting lists, but any reasonable person would suggest that a reduction, such as closing services at 5 p.m., would have an effect. It is a policy issue, which is the Minister's responsibility.

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