Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I thank Deputy O'Sullivan for sharing her time.

There is something deeply sick and shameful about a society where wealth and luxury are valued to such an extent that exclusive hotels, golf clubs and health resorts can be developed and built in a short time and supported by tax breaks for their wealthy owners, while very ill people have to wait for years in dangerous and disgraceful conditions before they see even the prospect of better facilities. Such is the case with cystic fibrosis sufferers in this State. The Pollock report was completed in 2004 and published in 2005. It has not been implemented and people with cystic fibrosis face waiting lists, overcrowding and dangerous exposure to infection, all due to the scandalous neglect of successive Governments.

I welcome and support the motion in the name of the Fine Gael Deputies and the priority given to cystic fibrosis among the health issues addressed in it. The response of the Minister for Health and Children to my parliamentary questions and those of other Deputies is not good enough. Every effort must be made to provide all the facilities required for people with cystic fibrosis, as recommended by the Pollock report. No excuses will be accepted. Once again we are debating a Private Members' motion highlighting the perilous state of our health services due to the fundamentally flawed policies and mismanagement of the Government and the HSE. A look back at the past month alone shows the depth of the ongoing crisis.

People in the north east region, comprising Counties Cavan, Monaghan, Louth and Meath, are incensed by the programme of cuts across all hospital services and at every hospital site in the region revealed in the leaked HSE memo. Yesterday it was confirmed in the Irish Medical News that the plans for the north-east region were discussed at the December meeting of the HSE board and that these plans will be the blueprint for cuts in every region throughout the State. This is something we in the north east, particularly those campaigning to save Monaghan General Hospital, have repeatedly pointed out. The knives that will be used to cut services in other regions have been tested and sharpened on the people of our region, particularly the people of County Monaghan.

What will the Fianna Fáil Deputies from Counties Cavan, Monaghan, Louth and Meath do about it because they are the people with the greatest opportunity of making a considered impact on Government, Department and HSE thinking? There is no use in them shaking their heads or tut-tutting to constituents and blaming the Minister, Deputy Harney, or their own party leadership for the 1980s style cutbacks that the HSE is preparing to impose in our hospitals. This week in the Dáil they have the opportunity to make their voices heard by supporting this motion or, at least, refusing to support the Government amendment. They must make a stand. It is not good enough that Opposition voices are continuously crying out for this to stop while others are clapped on the back and nothing more.

I challenge these Fianna Fáil Deputies individually and collectively to make their voices heard. Instead of voting tomorrow night they should meet and devise a common approach to help ensure these cuts do not proceed. They must take some initiative. Lobbying the Minister or coming back with a reply to this, that or the other does not make the critical difference.

The proposed slashing of services includes the closure of ten beds at Monaghan General Hospital, the reduction of outpatient clinics to four days per week in Cavan and Monaghan General Hospitals, the reduction of elective surgery to a four-day week in Cavan and Monaghan and the taking of Monaghan "off call" completely, rendering its medical and treatment room redundant. I respectfully challenge Cavan-Monaghan Fianna Fáil Deputies Rory O'Hanlon, Brendan Smith, Minister of State, and the newly elected Deputy Margaret Conlon. Will they support the Government amendment and simply troop in behind the Taoiseach and the Minister for Health and Children while pretending to the people of Counties Cavan and Monaghan that they are doing something to stop these cuts? I say to them, please do not take the people of Cavan and Monaghan as fools. I have no doubt that each and every one of us will be judged not by what we say but by our actions. Those Members have an opportunity and they must grasp the nettle and show leadership on these issues. Let there be no mistake about it, If they did that, the Opposition voices representative of that constituency would row in fully behind them.

Cuts are also planned in orthopaedic surgery at Our Lady's Hospital in Navan, elective surgery at the Louth County Hospital in Dundalk and outpatient clinics at Our Lady of Lourdes Hospital in Drogheda. What of the Fianna Fáil Deputies in Counties Meath and Louth? What will the Ministers, Deputies Dermot Ahern and Noel Dempsey, Deputies Johnny Brady, Thomas Byrne, and Seamus Kirk and the Minister of State, Deputy Mary Wallace, do about the cuts in their counties? That is what it comes down to, individual Deputies recognising that they are messengers of their constituents. These cuts are but a foretaste of the full implementation of the Hanly and Teamwork reports in the north east and throughout the State.

It is all a colossal fraud because to justify the cuts in hospital services and the over-centralisation of services in a few major hospitals, the Minister and the HSE repeatedly cite the key role to be played by primary care services, which they claim to be greatly improving. However, where are the more than 100 primary care centres we were promised in 2001? Far from improving, we are now facing a new crisis in primary care because of the shortage of general practitioners. The north-east region again has been the first to sound a warning, with the Irish Medical Organisation highlighting the low number of GPs and the pressure they are under. We have an ageing GP population, not enough trained GPs coming through and not enough GPs choosing to treat medical card patients. The crisis has been compounded by the HSE's refusal to fund the additional GP training places needed to bring the numbers up to the recommended 150 in 2008. The number of patients per GP in this State is too high. The present system and the Government malaise on this issue are a recipe for yet another health care crisis.

Two years ago A Vision for Change was published and it promised a new beginning in mental health services. Progress since then has been far too slow and the reality is that people with mental illness are still being badly let down by the Government. Mental health remains the most neglected sector of our health services. It is again a scandal that the Minister for Health and Children, Deputy Harney, and the HSE have failed to produce and to carry out an implementation plan for A Vision for Change. Essential improved services were promised but they are not being provided and staff are not being appointed because of the HSE recruitment embargo, as highlighted by the Irish Mental Health Coalition. While additional funding for mental health was allocated in 2006 and 2007, no additional money was provided in 2008. This is doubly damaging, as it was revealed that nearly half of the €50 million allocated in 2006 and 2007 to implement A Vision for Change was spent in other areas.

Despite all their fine words, the Government is failing to deliver for people with mental illness and it must continue to be challenged on this until A Vision for Change is fully implemented. I cited the tightening of the recruitment ban by the HSE and the damage it is doing in the area of mental health. That is true across all the front line of health care and is leading to further hardship for patients and a further lowering of morale within the health services. I could cite many other specific and pressing health issues if time allowed but I will conclude with just one. The Irish Family Planning Association revealed last month that the number of Irish women dying from cervical cancer continues to increase every year, despite the fact that this disease is entirely preventable through screening and vaccination. There is still no sign of a national screening programme in this State nor a decision on whether the vaccine is, in the Minister's own words, "cost effective". What does she mean by that? How many women's lives are worth the cost to this Government?

All I ask is that the situation is changed. I urge everyone concerned with our health services to unite in the demand for equality, excellence and the care that all our people deserve. I hope Government Deputies will accept my challenge.

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