Fergus O'Dowd (Louth, Fine Gael)

This is a very important debate which goes to the heart of the purpose of our society and health services. Our services are a measure of how we treat the very young and old in our society, the type of people we are, the type of country we have created and how we manage and run it. In the case of these very young children any necessary help, support and money should be given to the hospital or hospitals which treat them. Whatever services are needed and whatever medical specialties are required must be provided. This is the bottom line for our society.

Let us put down a basic benchmark of a human, just republic which we all seek and which cherishes all our children equally. If we can help young children who have a medical problem or a disability to live a longer, better life then that is the measure.

As in the case of other speakers, I wish to address in a constructive way what should happen in our society. The Minister for Health and Children has failed in her duty of care to provide the moneys for these operations and to consider the necessary processes.

As transport spokesman in my party I examined the transport costs associated with health care. In 2003 the HSE transport costs came to €18 million total. In 2008, the latest year for which the figures are available, the figure is in excess of €29 million, an increase of some €11 million from the 2003 cost of providing transport in the health services area. Our argument and that of Deputy James Reilly, the Fine Gael health spokesman, is that it is surely possible to find savings in the area of transport policy to provide the moneys necessary for this hospital.

Let us examine the facts. I have read the relevant details and acute hospitals throughout the world have an effective transport policy and in many cases a green transport policy. Such policies reduce costs and the carbon footprint but provide essential services to people in an effective way. In the past two years the HSE spent €60 million on transport policy, compared to a figure of €20 million in 2003. There has been a significant overrun in this area. Let us consider the staff taxi costs of last year. In one area, that is, the mid west the transport spend last year was almost €150,000, in the east coast area some €162,000 was spent on staff taxis, in the south west more than €277,000 was spent, but in the north east only €1,340 was spent. Clearly some areas have an effective transport policy for their staff and others do not. The Minister must examine the matter. Some areas work very well and others are not working as well.

Another matter arises in the reduction of costs associated with the transport policy for patients. Appointments are made in such a way that when a patient is notified of an appointment, public transport options are provided, including how to reach the destination and the associated costs. This can be done quite easily. Many people must travel from rural areas to cities and in many cases long distances are involved. Such people require essential and important treatment and are often very ill. However, if one provided transport options upon making the appointment along with the costs of same it would provide alternatives. The cheapest possible option, if public transport is available, would effectively underline the importance of ensuring that moneys available in the health services are used to provide the medical expertise at the point at which it is needed. Other essential costs can and must be reduced. Why is it not possible to save €6 million for Crumlin hospital in our transport policy? It would make a good deal of sense to do so.

I understand many people must travel long distances to attend specialist care. If someone has cancer he or she must go to the appropriate regional centre. If a person suffers from serious kidney disease he or she must go for dialysis elsewhere. I understand in other countries a volunteer programme is in place. A similar programme might operate here which in the case of cancer care could be operated through the hospice movement. A volunteer programme for kidney dialysis treatment could be operated by survivors or people who have had such illnesses. They might offer or be available to drive patients to the treatment centres. If such a voluntary network were built up and supported in association with the hospice movement and strategies were put in place it would make a significant difference to the cost and the quality of concern expressed by the community on behalf of sick people. The community could lend its support and empathise with sick people during an illness. The Minister must think again about the way in which she manages the budget. She must re-examine how to reduce some costs and make it more practical and realistic to get patients to the point of treatment. The bottom line is it is possible to make such savings if they are sought, but the Minister has not done so up to now.

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