Arthur Morgan (Louth, Sinn Fein)

I welcome the opportunity to speak about this Bill. A substantial amount of clarification and explanation is required. I hope to raise some questions. My colleague, Deputy Ó Caoláin, spoke in detail about this Bill recently. I suppose that gives me some latitude to look at the general position of the HSE and the provision of health care in this State. I remind Deputy Tom Hayes that the HSE is not responsible for the closure of hospitals throughout the State. The withdrawal of essential health services across this land is Government policy. The HSE is used as a mudguard to collect blame. The reality is that the HSE will do what it is told to do, by and large, by the Minister and in accordance with Government policy. I need to correct that misnomer at the outset.

Earlier this afternoon, I was told the hospitals in Wexford, Clonmel and Dundalk will be closed at the end of June, in effect, as no registrars or anaesthetists will be appointed to them. We already know that the appointment of junior doctors to Louth County Hospital for training purposes will cease on 30 June next. As a consequence, all acute medical services at the hospital will have to be transferred to Our Lady of Lourdes Hospital in Drogheda, which is already grossly overcrowded. This is a specific policy intention of the Government. There is a shortage of junior doctors at present because the Government made it much more difficult for junior doctors from outside the EU to get positions here. The Government has refused to recognise or accept the standard examination that is carried out in Britain. Applicants for junior doctor positions have to deal the significant delays and expenses associated with the similar - almost identical - test that applies in this State.

It is clear that the Government does not want additional junior doctors. It is much happier to close essential services and to corral health care into a number of bigger hospitals. Our Lady of Lourdes Hospital in Drogheda, which is such a hospital, is full to capacity. The hospital's accident and emergency unit, which was developed at a cost of €11.5 million, is waiting to be opened. It cannot open because sufficient staff are not available at present, largely as a result of the cap on recruitment. In some cases, people have to sit on chairs and trolleys in the existing accident and emergency unit for 36 or 40 hours because they cannot be moved into the new modern facility.

The difficulties that already exist in Drogheda will be substantially compounded by the arrival of significant numbers of acute patients from Louth County Hospital in Dundalk. The accident and emergency department, the intensive care unit and the male and female medical wards will be transferred from Dundalk to a hospital that is already grossly overcrowded. Is that good health care management by the Government and the Minister? I do not think it is. It is disgraceful.

The whole situation regarding anaesthetists, registrars and junior doctors needs to be dealt with by the Government as a matter of urgency. Unfortunately, I do not see any effort on the part of the Government to do so.

In fairness, it must be acknowledged the run-down of the health service in Louth County Hospital had started before the Government took up office. It commenced approximately 20 years ago. In 2001 the children's ward closed, follow by the maternity unit, the obstetrics and gynaecological ward and their services transferred to the Lourdes hospital in Drogheda.

Women and children first, a bit like the Titanic. The comparison is apt considering the Government, if it has its way, will sink the essential services for in excess of 100,000 people in the greater Dundalk catchment area. They will be crowded into the already overcrowded hospital in Drogheda.

The solution, it was claimed, was there would be a new modern, and state-of-the-art, midwife-led service provided at Louth County Hospital. Women throughout Britain were meant to be opting for this type of service. A similar service was located in Bristol which was supposed to be operating successfully. This was pure bunkum and lies. We were misled by those statements from the HSE, Health Service Executive, and local politicians both at council and Oireachtas level. The midwife-led unit never opened. The unit in Bristol that we were told was all-shining, terrific and modern we then learned had serious problems.

Women in the Dundalk area now have to decide to travel to the Drogheda maternity unit which has its own problems. Until recently, that unit's mid-wife complement was grossly understaffed. The international standard for midwives is 1:25 births. In Drogheda for a considerable time, it was operating at a complement of 1:48 births, almost double the international standard. I acknowledge it has begun to come down, an improvement of 1:35 births. It still, however, is a long way from meeting international standards to which women in the area entitled. Mothers-to-be in Dundalk have the other option of attending a private practice across the Border.

These choices are grossly unfair and come down to the nub of the Government's health policy. It is trying to privatise as much of the health service as it possibly can. It is trying to shut down public services and cajole patients into private health care. Its promotion of private health care has already been demonstrated by its huge tax incentives for private hospitals.

The Americanisation of the Irish health service is well under way. Up to 50% of the people of this State have opted for private health care because they have no other alternative as proper public health care services are not in place. This element of public health care provision, a responsibility of this and preceding Governments, is completely ignored. This is unacceptable.

If I were in charge of this Government, I would not allow the Minister for Health and Children, Deputy Mary Harney, to clean out a toilet in a hospital much less run an entire health service. She is neither competent in nor cares about dealing with the difficulties faced by the health service. The Government is happy, due to the politics of the situation, to allow her carry on being Minister to a service that is grossly underfunded and understaffed. The staff in Louth County Hospital no longer walk but run from bed to bed because of the pressures of understaffing. It is an indictment of this Government, the other Fianna Fáil-led ones over the past 13 years and their predecessors.

Wexford, Nenagh, Louth, Sligo, Monaghan and Navan hospitals, essential health care services to their localities, will be closed down by Government policy. Those first affected by these closures will be women, children and older people. They will now be required to travel ever longer distances to access health care. This is an indictment of the Government's scandalous and unacceptable health policy.

Bring on the next general election because I hope the people of this State will give the Government the electoral result it deserves. Never mind the banking crisis, what is going on in the health service is just as big a scandal. It is a scandal in the provision of fundamental public services to our society. This Government does not care about society; it does not have a social conscience. All it wants to do is bail out its greedy and corrupt banker and speculator friends.

By this I am not referring to those working in the banks serving members of the public at the front desk. They are the hard-working but underpaid, doing a decent job. I am referring to the senior executives in the banking services that are corrupt.

I am also referring to those the senior people in the HSE, those from a professional medical background, who know what exactly they are doing in their administration and closing down of the services. Of course, they will be all right because if they ever decide to go back into medicine, there will be a position for them in privatised hospitals. These very hospitals were incentivised to the tune of 100% by the taxpayer for construction and kit-out costs with a 15% allowance for the first six years and 10% for year seven.

This specific Government policy does not care about people who cannot afford private health care. This is a Government that does not care about the sick. It only cares about the golden circle, evidence of which we see in this Chamber every day when debating these matters.

When the National Treatment Purchase Fund was introduced some years ago, its purpose we were told was to shorten the lengthy waiting lists for people who needed essential care. While I support this scheme because it facilitates, say, pensioners' hip replacements in the private health sector if they have had to wait over three months, it must be seen that the Government never sought to make proper provision for hip replacements in the first instance. It has become the standard to funnel these public patients into the private health system at huge costs to the taxpayer when public provision should have been made in the first instance.

The fact people are willing to pay exorbitantly for private health insurance suggests to me they would be willing to pay a specific additional percentage in taxation that would be ring-fenced for the proper provision of health care. Is that happening? No, because the Government wants to Americanise the whole Irish health care system, which is a scandal.

I have referred to the Louth County Hospital and Our Lady of Lourdes Hospital, Drogheda both of which are within my constituency but let us consider Monaghan General Hospital for one moment. It does not have the same catchment area as Dundalk, but does that mean the people of Monaghan are less entitled to health care service? The hospital has been in place for more than 50 years and has served the people of that area well. Why is it being closed now? We are informed it is because of re-configuration. That represents only a buzz-word to me, learned from public relations people who, in turn, sourced such terms from the beginning of the buzz-word era with the Americans and the Vietnam war. This might appear to be a lengthy connection but it is a fact. Re-configuration was a buzz-word introduced to try to bluff people who might believe that such people know what the are talking about when they use such words. However, they are simply referring to cutting back a service, in this case for the people of Monaghan and its catchment area. The local hospital has served the people of Monaghan very well for more than 70 years but it is now closed or virtually closed. There is no acute medicine in place and no accident and emergency department. Patients from that area are being sent to the Cavan General Hospital at the moment. The people in the Cavan area might believe that is a great thing and it means their health service is being maintained and functioning but only in the short term. It is only a matter of time until Cavan General Hospital patients will have to travel the additional journey to the already overcrowded Our Lady of Lourdes Hospital, Drogheda. This hospital in turn will be still further overcrowded by the patients from Dundalk, never mind the people from Cavan coming down.

It is worth noting that for the people of Blacklion, Cavan, in the west of that constituency, there is a 100 plus mile journey to their nearest hospital. This is the result of what is happening in the north east and the people of Cavan need to know as much in advance of the next general election. Soon, they will be expected to travel. Let us remember we are discussing people who are ill, who are about to be admitted to hospital, who are sick and who need attention. The last thing one should do with someone who is unwell is to send them on a 100 plus mile journey to the nearest hospital for acute medical care, but that is exactly what Government policy is forcing the people of Cavan and Monaghan to do.

I refer to the Louth County Hospital, which is about to close for all intents and purposes. It will not close completely. The doors will be open and it will deal with some endoscopies, minor procedures and cuts and bruises but it will deal with nothing serious. We were promised a minor injuries unit in the Louth County Hospital but I will not hold my breath for that to happen because I do not believe it. However, if it does take place, no service will be adequate to replace what has been in place for 50 years now, that is, a proper, functioning accident and emergency service.

The people in Meath, especially in the Navan area, need to know that the services of Our Lady's Hospital, Navan are already being run down and it will be closed as well. There is a slow burn in place and those working there have already been put on notice that re-configuration will take place. The people who use that hospital will have to travel a substantial distance for health care.

I intend to use my last two minutes to say it is a shame, not only on this Government and its Ministers, but on every Member who votes in favour of the Government. It is scandalous that, time after time, certain backbenchers get up and walk through the lobbies and vote for this policy which is grinding down our health service. The Minister for Health and Children is somewhat like an absentee landlord. She shows up here once in a blue moon but has shown no diligence, interest or enthusiasm for the position she holds. She should go. In fact, she should be sacked and put out the door for neglect of the service. Similarly, the Government should be told to go as well. I look forward to an early general election to give the people an opportunity to give an answer to this Government once and for all and to say to it "No more". It should turn this policy around to give a proper health care service to everyone in the State not only to the millionaires who can afford it, but to the ordinary people wherever they come from. People should have reasonable access to a proper health service no matter what the size of their bank account.

See this speech in context