Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)

Deputy Spring stated that the overall financial context in which the health service plan has been introduced is not related to the payment of bonds. The implication is that the problem to be resolved is the deficit. It is important to challenge this notion. While many of the bonds have been paid, the cost of doing so has been transferred to the sovereign debt. Nationalising bankers' gambling debts was a mistake and it is the reason the deficit is so bad. While we also have what is known as a structural deficit, the decision to socialise more than €100 billion of bankers' debts spells disaster for the economy and society. I still believe we should repudiate these debts. We must challenge the European authorities and fight on this issue because it is simply not fair or sustainable, either socially or economically, to assume the debts of bankers. I reject as a starting point the notion that we must accept these parameters. We must resist them and I will explain the reason it is necessary to do so by referring to one the most important elements of our society, the health service.

If the cost of taking on the gambling debts of bankers is to inflict serious damage on the ability of the State to provide adequate health care to its citizens - the sick, vulnerable, elderly and young - that price is not acceptable. It is clear that this is the case as an examination of this year's service plan for the Health Service Executive makes clear the terrible price we will have to pay for this decision.

Health is one of a number of very important areas. Before I address the health plan, I will first place on record the position as regards the so-called structural deficit. If we repudiated the socialised banking debt, our deficit would be at manageable levels and we would almost certainly be able to access funds on the international markets because they would consider Ireland a reasonable bet in terms of our ability to repay our debt. It is precisely because our deficit has been compounded by the gambling debts of bankers following a decision that effectively doubled the deficit that the international markets do not believe we are not in a position to repay our debts and will not lend us money.

We also have the matter of the depleted tax base, which is almost entirely a consequence of the policy pursued for a decade by the Fianna Fáil Party of reducing taxes on wealth and big business to unsustainable levels. Previous Governments conned people into believing this policy was good for the country because most people did not examine the detail of the Fianna Fáil approach during the boom. As it transpired, the boom was a bubble for which we are now paying the price. The way to address this problem is not to slash services but to reform the taxation system to ensure those at the top of society pay their fair share, as they are well capable of doing.

Having set out my complete rejection of the economic and financial justification for the cutbacks and austerity measures the Government will visit on the health service, I will focus now on the health service plan for 2012. In summary, the plan attempts to spin and justify terrible cutbacks in the health service which will cause great suffering for the most vulnerable sections of society. The Government is trying to spin it as reform in summing it up with the ludicrous slogan, "more for less". Neither the Government nor the Minister for Health believe their own slogan, which is merely an attempt to put a brave face on a savage attack on the health service. Let us be honest, this is a plan to further slash vital health services for ordinary, vulnerable citizens. I hope the Government will make a clean break by desisting from the type of play-acting the previous Government engaged in when terrible things occurred in the health service as a result of inadequate funds and resources. At that time, the Minister and his Department blamed the nasty Health Service Executive for everything that went wrong as if the Government could distance itself from the HSE. Last month, RTE's health correspondent, Fergal Bowers, put it well when he described the Minister for Health's rejection of the initial draft of the health service plan for 2012 as akin to sending a letter to oneself to complain about oneself given that departmental officials make up half the board of the HSE. The Government should not attempt to abdicate responsibility for the health service. We are familiar with this policy from the Fianna Fáil and Progressive Democrats parties. Let us have none of that. Responsibility for the delivery of health services lies with the Government and Minister.

The key issue in the health service is whether we have sufficient numbers of doctors, nurses, administrators, cleaners and other professionals required to make the service work. The crucial element of the health service is to have people with skills in place to help sick people, although resources and infrastructure are clearly also necessary. If the number of health service workers is cut to the extent set out in the plan, it is utterly preposterous to suggest we will get a better health service. The "more for less" slogan is dishonest and should be dropped.

Since 2008, the number of health service staff has been reduced by 7,000 and the plan envisages reducing it further, from a current level of 104,000 to 95,000. This will result in a worse health service. As the HSE plan acknowledges, cutting €750 million from severely overstretched and inadequate services will result in a serious decline in the quality of the service provided. HSE management does not believe one can get more for less. According to the plan, "The issue most directly impacting on the levels of services to which the HSE can commit is the number of staff who will be available next year to deliver our frontline services".

It is clear it will not be possible to deliver all services at the same levels as previous years. It only promises to deliver the maximum level of safe services possible for the reduced funding and employment levels, including addressing, in so far as possible, the unstructured nature of downsizing. In other words, it will do its best but the level of service provision will be considerably less. It states clearly that efficiencies, about which the Government talks along with restructuring and so on, will not compensate for the loss of front line health care delivery staff in such large numbers. The estimates here may not even be accurate. There are already indications, as reported on RTE recently, that rather than the 3,000 whole-time equivalents by the end of 2012 suggested in the plan, it may be 3,500.

The Health Management Institute said recently that it believes continuing to provide services with the reduced resources available in certain areas will compromise the quality of services provided and will also impact on risk. That is the reality.

We are talking about a health service in which, with fewer resources and fewer staff, there will be less service provision, more suffering and people unnecessarily dying. That is true also in the mental health area. If one looks at the situation with Louise Bayliss before Christmas, what was that ultimately about? Ultimately, it was about cuts in staff and in resources in mental health services.

We are sacrificing the quality of our health service, which is there to protect the sick, the vulnerable and the elderly in our society, to pay back the gambling debts of bankers and bondholders. That is the truth and it is a shame on any Government that it would allow that to happen. The United Left Alliance will continue to robustly resist that agenda.

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