Sandra McLellan (Cork East, Sinn Fein)

The health service is in crisis. It was in crisis under the Fianna Fáil-Green Party-Progressive Democrats Government and is in crisis under Fine Gael and Labour. Across the State, people have become painfully accustomed to the familiar HSE approach to so-called reconfiguration. It starts with a series of cuts, the non-replacement of staff, a little bit here, a little bit there. Along comes a report claiming the hospital or department is no longer fit for purpose or with some story about an insufficient throughput of patients. This is usually followed by the promise of a "local" centre of excellence some 50 miles away. Following this comes cutbacks, downgrading and closures and the centre of excellence never materialises.

In Cork East, the centre is still Cork University Hospital. It has received no extra beds, facilities or staff. Indeed, fewer staff are doing more and more in more dangerous conditions. This is just October - imagine what it will be like in December and January.

The Government is intent on downgrading emergency services in a number of rural hospitals, including at Mallow. The blueprint was provided for in the HIQA report and piloted in Roscommon. The process cannot be allowed to continue. In addition to this onslaught on hospital services, pre-hospital emergency services are being devastated. The proposed reconfiguration of the ambulance service in the HSE south area could leave Youghal without ambulance cover. This is unacceptable. These proposals, particularly in the context of the devastating cutbacks planned for the emergency department at Mallow, amount to an unprecedented assault on acute emergency health care in the region. A rapid response vehicle manned by paramedics is not the same as an ambulance manned by advanced paramedics.

It is clear to the dogs on the street that the Government's strategy makes no sense. Services at every level are being slashed. Out of hours primary care, emergency care, pre-hospital emergency care and convalescent care are under attack with no sign of replacement or alternative services. All of the evidence indicates that these moves will cost lives. The time for words and five-year reprieves is over. People need to see real change and improvement.

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