Tom Fleming (Kerry South, Independent)

The €750 million reduction in this year's budget from the 2011 budget allocation is a dramatic shortfall, which imposes a great challenge to delivering an adequate service in 2012. Of immediate concern is the anticipated loss of 3,500 workers under the redundancy scheme by the 29 February deadline. A huge mistake was made when the redundancy package was announced because guidelines were not specified and neither were the numbers of people being allowed to avail of the package in each health care discipline. It seems we will have deficiencies in some hospital sectors. For example, rumour has it that a disproportionate amount of nurses in some specialties are applying for redundancy. There is also an overdraw in midwifery. The HSE report admits to the unstructured nature of exits for different services. The report also refers to a replacement factor pay model of €16 million for critical posts. The report admits that this represents a very limited capacity to address what will no doubt be critical gaps in the health service.

Existing staff will be overloaded and thus under strain in coping with additional demands. The HSE report also states that agency staffing is to be reduced by up to 50%. It is clear that the Minister for Health will have to devise some contingency plan for this situation. Due to the negative impact on health services, there is an urgent need to review the embargo on recruiting graduate nursing staff. Even if they were only to be employed on a part-time basis to deal with what I predict will be a mini-crisis, it would ease the dilemma as well as giving these graduates with excellent qualifications an opportunity to pursue their careers in their own country.

I welcome the additional €55 million for nursing homes, which is additional to the sum of €1.049 million already provided for the nursing home support scheme, which is better known as the Fair Deal. This sum should be concentrated on public care homes, rather than private ones, as well as semi-public and voluntary care establishments. Valentia Community Hospital, which is in receipt of financial support from the HSE, should also benefit from this additional allocation. It would enable it to continue its high quality service to that island community and the surrounding catchment area.

There are rumours circulating that a disproportionate number of long-term beds for the elderly will be taken out of service. This is causing widespread anger and concern among people in County Kerry, so the Minister should clarify the matter. District community hospitals, including St. Columbanus's nursing home in Killarney, have provided sterling service to the senior citizens of the county over many years. Following improvements to upgrade such facilities, it would be totally out of order to interfere with these institutions.

It is estimated that some 23,611 clients will be supported by the nursing home scheme by the end of this year. This is an increase of 1,270 from 2011. We definitely have adequate beds in our public institutions, such as those I mentioned earlier, but there should be no further drift of spending to private hospitals at the expense of public ones. I welcome the fact that Kerry General Hospital in Tralee and Kerry community hospitals combined with St. Columbanus in Killarney, had no budget deficits last year. This merits enhanced funding based on their performance and high standards.

The allocation for disability services is being reduced this year by 3%, which is downright uncivilised. It will lead to further neglect and deprivation of essential back-up services for the most needful in society. The 14-month waiting time for appliances for such people in the Kerry-Cork region is unwarranted and unacceptable. It should be dramatically reduced as it is inconvenient and stressful for people waiting for prostheses or second skins, for instance.

I welcome the €1 million for autism services, which for a long time were deprived of necessary funding. These moneys should be further increased next year to develop early intervention teams. Autism needs to be addressed step by step in the coming years in order to provide the attention it deserves.

The additional €35 million for mental health services is also welcome. The recruitment of 400 staff nationwide is most positive for these services, which are faced with increasing demands daily. The Minister should proceed with the closure of St. Finian's Hospital in Killarney and finalise arrangements for alternative accommodation at an early date.

I commend the development of primary care services, which are wonderful, progressive developments throughout the country. I ask the Minister to progress with the HSE the further provision of primary care services, which are most beneficial for rural communities and particularly for people living alone in isolated areas.

See this speech in context