Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I thank Deputy Jan O'Sullivan for sharing her time. I want to begin my contribution in support of this motion by congratulating the people of County Clare who turned out in such numbers in Ennis last Saturday in defence of their hospital. Some 5,000 people took to the streets to oppose the disgraceful decision of the Government and the HSE to axe 24-hour accident and emergency services at Ennis General Hospital. If such a demonstration had taken place in some quarters of this city, I have no doubt that RTE and some of our so-called quality newspapers would have covered it extensively, but this significant event received scant attention in the national media, thus suiting the agenda of the Taoiseach, the Minister and the HSE, the hospital services centralisation policy of which treats communities in the regions outside Dublin with contempt.

It is scandalous that the HSE is imposing a ban on recruitment of staff at hospitals and other health care facilities in a cost-cutting exercise on top of ongoing backlogs and delays in the appointments of frontline staff in our health services. There is a shortage of health professionals across a range of services and further hardship is being imposed on patients as hospital waiting lists will inevitably lengthen as a result of this decision.

During the general election, Fianna Fáil, the senior partner in the coalition, urged people to support it to take "the next steps". It seems the next steps are health care cuts in the public system while the Government carries on with its disgraceful plan to reward the private for-profit health system with public land and tax breaks under the notorious co-location scheme. The HSE has cited an alleged overspend of €140 million by hospitals to justify these cuts, but the HSE announced last July its final abandonment of the failed PPARS computer system, which cost €130 million by 2005. The Government and the HSE are jointly responsible for failed policy and gross mismanagement, leading to poorer care for patients.

The disadvantaged parts of the health service will be worst hit by the recruitment freeze. Earlier this year, the HSE announced 60 new consultancy posts for hospitals throughout the State, but none of them was allocated to the north-east region comprising Cavan, Monaghan, Louth and Meath. The current HSE cuts serve to compound that gross injustice.

The health service unions are fully justified in contemplating protest action. The false claims by the Minister and HSE chief executive Brendan Drumm that the cuts will not affect patient care are being fully exposed with hospitals having to curtail services. The Taoiseach has remained silent on these cuts while both he and the Minister have attempted to hide behind the HSE, but they cannot shirk their responsibility for these unnecessary cuts. Despite the vibrant economy of the past decade and a HSE that the Minister claims has streamlined the running of the health services, the Government is still presiding over fundamentally flawed policies and gross mismanagement, leading to poorer health outcomes for public patients. I emphasise that they are public patients.

The health service unions deserve public support in their efforts to resist these cuts. It is right for the motion to refer to the dismantling of key services at Ennis. As a Cavan-Monaghan representative, I know all too well the devastating effect of the axing of vital accident and emergency services. Lives will be lost. Further pressure will be put on neighbouring accident and emergency departments that must cope with the additional patients who would normally have had access to the closed units. These are the facts.

Currently, some 15% of the population are more than one hour travelling time from an accident and emergency unit. If the notorious Hanly report is fully implemented, that percentage will rise to 30%. Nearly one third of the population will be more than an hour from accident and emergency units with the inevitable result of lives lost. Despite this, the Government and HSE centralisation drive goes on without the fully equipped and fully resourced ambulance and paramedic services being put in place as promised.

In August, a survey published in Britain confirmed the link between distance travelled by ambulance to hospital emergency departments and the risk of death. The survey published in the Journal of Emergency Medicine confirmed that increased distance from the departments is associated with an increased risk of death. The Government must heed this warning from the neighbouring island, which adds to the voices of communities throughout the State which feel threatened with the loss of accident and emergency units.

The findings of the survey may seem obvious and it is all too tragically so for the communities served by Monaghan General Hospital, which have seen deaths as a result of the longer journey times imposed by the cutting of services at our hospital. However, this is an important study because it was carried out in the context of the British Government's proposals to close accident and emergency units in smaller hospitals. I hope this issue will be revisited.

The policy pursued by the Minister and the HSE to dangerously over-centralise all acute emergency care services has been repeatedly rejected by the people. The Minister should not cite the recent general election results as an indication of approval for her reappointment or the configuration of the Government, as nothing could be further from the truth. The Government must scrap its policy and ensure that existing emergency services, including hospital emergency units and ambulance services, are enhanced and developed. Closed or curtailed emergency units, such as those at Monaghan, must be fully restored. The threat to Ennis and other hospitals must be lifted. It is time for the Minister and others with responsibility to realise that nothing less is acceptable.

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