John Browne (Wexford, Fianna Fail)

I welcome the opportunity to discuss the health service plan 2012. The plan, if one could call it that, proposes to reduce the overall health spend by €750 million. This leaves €14 billion to be spent on the health services during 2012. One would expect €14 billion to be sufficient to provide an adequate health service for the people. However, as is the case with any plan from the HSE, the cuts begin with the most vulnerable and the least well-off in our society. The consultants, doctors and senior management at the top are usually left to one side and they are not obliged to take the necessary reductions to bring about savings. Deputy Twomey referred to efficiencies. Surely efficiencies should start with the leaders in the HSE. There are enough managers throughout the country to devise a practical plan.

The Minister has okayed the plan before us this week. At first he sent it back to the HSE but he approved the plan eventually. This was a window-dressing exercise by the Minister to allow him to wash his hands of the plan. We are all aware that the Department of Health and the HSE have worked hand-in-hand to draw up a plan for the health service in the future.

Let us consider the implications of the plan in my area in the south east. Leaks have come from Waterford Regional Hospital in recent weeks. We will see the closure of three of its eight operating theatres. Elective procedures are set to be hit first. Waiting lists for specialist surgery will lengthen and there will be some restrictions in respect of specialist drugs as well. Let us consider the case of Wexford General Hospital. It is difficult to get information about Wexford General Hospital. However, I have done some investigative work in the past week involving staff within the hospital. They have informed me that approximately 55 staff will be lost to the hospital because of redundancies, retirements and people leaving the service. The medical admissions unit will close at weekends, from Friday evening to Monday morning, orderly security will be cut and some wards will be closed at night time. This will have a devastating effect on the hospital.

The two major hospitals in the south east will suffer from the severe reductions in the services available to the general public. Before he concludes the debate, the Minister should explain fully the reductions that will come about because of the HSE plan on a hospital-by-hospital basis. I understand there will be a reduction of €1 million in the ambulance service budget in the HSE south region. This will seriously affect the ambulance service in the south east region, which both Deputy Twomey and myself represent.

I refer to the ongoing medical card debacle. I have before me a file containing 140 medical card queries from the people of my county, some of which date back to last August when those involved first applied for a medical card. These people have not yet received a medical card. There are delaying tactics although I do not suggest the Minister is deliberately delaying the issuing of medical cards. The centralising of the issuing of medical cards took place on our watch. Many backbench Fianna Fáil people objected at the time to the centralisation of the medical card system because when it was operated on a county-by-county basis, people were able to get a medical card reasonably quickly and if there was a problem they were able to go to the local medical card office and sort out the problem. Now one must telephone the medical card office in Dublin. The staff there are not to blame - they are doing their best - but there is a difficulty because of the vast number of medical card applications which they must process in one office in Dublin. It is scandalous that people have been waiting since last August or September for their medical cards.

I realise Deputy Twomey and other doctors have been trying to provide this service in the hope that people will eventually get their medical cards but doctors are getting fed up of this as well. In addition, chemists are becoming fed up of supplying the drugs in the hope that people might get a medical card at some stage in future. It is not good enough for the Minister to have stated in the House last week that there is a 15-day turnaround for the issuing of medical cards. This is not the case. Certainly, it is not the case in my county and I doubt whether it is the case in any other county. There may be a scarcity of staff but it is important that staff are put into the medical card offices in Dublin to clear the backlog and to ensure that people who deserve medical cards get them quickly and on time.

There are cases of people suffering from cancer and other serious illnesses and they are being denied the medical card which would allow them to get the drugs they require. We know of cases where people are not going to the doctor although they are seriously ill because they do not have the medical card to cover the cost of the visit or the cost of the drugs required to treat the illness. Doctors and chemists in my county have done their best up to now but they are becoming increasingly annoyed with the ongoing delays. In some cases, they believe it is a cynical exercise to slow down the issuing of medical cards and to reduce the costs associated with them. I call on Deputy Twomey to ensure that the Minister, Deputy Reilly, increases the number of staff making decisions on and working on the issuing of medical cards.

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