Ciara Conway (Waterford, Labour)

I concede that, in the past, the dots were definitely not joined up. Consequently, we are facing one of the biggest crises to have challenged society. In the programme for Government, there is a plan for the health service. There is more planning now than ever before. A plan was absolutely lacking under the last Government because it threw bad money after bad decisions.

For the first time, we have a clear agenda for the development of community-based services. We all know there are considerable constraints and that all the reform will have to be cognisant of the target of cutting costs by €750 million. I acknowledge the difficulty but welcome the developments concerning children and families, mental health and primary care. The Government failed absolutely in the latter area, including in my constituency, Waterford.

Of the pilot projects that were supposed to have been rolled out under the last Government, a measly 11 were carried out successfully. There is a continuing problem with access to acute hospital services because primary care is not being offered as it should be. I have every faith in the ability of the Minister of State, Deputy Shortall, to make progress in this area throughout the lifetime of the Government.

Yesterday, the Minister, Deputy Reilly, outlined some of the goals of the plan. They are very ambitious. It is hoped that no hospital will have a waiting period of more than 12 months. As a new Deputy, I realise this is one of the most serious issues to be placed on Deputies' desks. Deputy Daly touched on it when she said the system is second to none when one gets into it but that the problem is trying to access it. I welcome the Minister's ambitious targets in this regard.

With regard to reform, I welcome the decision to establish a separate agency to deal with child protection and family services. These have been an issue for many years. The previous Government failed to deal with it and, unfortunately, there have been some very serious and unfortunate deaths of young people because of the failures in the system. I do not blame the workers in the system. I worked on the front line as a social worker but noted the system itself is broken. The Government has acknowledged that this is the case and it is willing to take a chance and put €40 million towards establishing child protection and welfare services to ensure best practice regarding these serious matters, which affect some of the most vulnerable children and families.

It would be remiss of me, as a Waterford Deputy, not to outline my very serious concerns about the south east and Waterford Regional Hospital. Last week the details on the forthcoming cuts that are to affect Waterford were made known in my constituency. We must wait for another couple of weeks, or perhaps one week, before they are made official. A few years ago, Waterford Regional Hospital was lauded for its value-for-money approach. It has the lowest staff-patient ratio of any major hospital. Recently, it passed with flying colours in respect of all the HIQA standards.

Waterford Regional Hospital has been neglected over the years in terms of funding for the development of services. Annually the hospital treats up to 200,000 patients on a budget of €145 million. St. Vincent's Hospital in Dublin treats approximately 184,000 patients on a budget of €250 million. Cork University Hospital, which is just down the road from Waterford, treats a very similar number on a budget of €277 million. What does this mean for the people of Waterford? In 2010, a decision was made to split the administration of the south-east area. There are now two integrated service areas which is a mistake because south Tipperary, Kilkenny, Waterford and Wexford are all vying for the same pot of money. Consequently, Waterford Regional Hospital has a lower number of staff and a smaller opportunity to treat people. The split across four sites gives rise to an issue of hospital governance. I am eager to hear from the Minister his plan to address the administration of health care in the south east.

At present, Waterford Regional Hospital is facing considerable cutbacks. Acute medicine, above all, is under serious pressure. The facility in Waterford, which is not well funded owing to a historical problem which I acknowledge, is to suffer from the same cuts as other hospitals with vast resources. Therein lies the inequality and my dissatisfaction.

The problem is such that Cork University Hospital, which treats the same number of patients as Waterford Regional Hospital annually, has five pain consultants while Waterford Regional Hospital has one. In St. Vincent's hospital, there are six cardiologists while Waterford Regional Hospital has two. I ask the Minister to consider this. A crude cut of 3% or 4% across the board will mean Waterford Regional Hospital will be further punished for delivering in respect of good practice and savings. It was asked to achieve the savings but it is now being punished for doing so.

Waterford Regional Hospital is facing the closure of wards and theatres. This reinforces regional inequality because those living closest to Dublin and Cork have a vast number of services on their doorsteps by comparison with those in the south east, which is facing very serious difficulties owing to high unemployment rates and job creation difficulties. This problem, on top of everything else, is of great concern.

Waterford Regional Hospital, despite its cost-saving measures and low number of staff, was one of the hospitals that met all the HIQA standards. If the cuts go ahead, where will it leave the hospital and its patients, my constituents, in terms of their being able to gain access to safe health care?

The welfare of people in the south east is under threat. I implore the Minister to examine this because of the manner in which Waterford Regional Hospital was disregarded by previous Governments. This needs to be put in context by the HSE and the Minister when implementing the plan over the coming 12 months. The south-east region, served by Waterford Regional Hospital, is the only region in the country that has no palliative care services. I have seen a letter written prior to the 2007 election, and signed by Mr. Bertie Ahern, promising the people of Waterford a palliative care centre but that was never delivered upon. I ask the Minister to consider the grave need of people who face challenges in regard to looking after very sick people. Nobody needs to be told how emotive it is to have somebody in one's family challenged with a very serious illness and faced with death while not having a palliative care service or unit in the area. I make that plea to the Minister.

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