Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

The Sinn Féin Deputies have no confidence in the Minister for Health, Deputy James Reilly, and we deplore the Government’s attacks on our public health services. We roundly reject its fundamentally flawed and inherited health policy. We will be voting accordingly at the end of this debate.

Ar dtús, molaim an leasú in ainmneacha na dTeachtaí Shinn Féin. Ní leor an rún ó Fhianna Fáil, páirtí a chur ciorraithe ar seirbhísí sláinte i bhfeidhm nuair a bhí siad sa Rialtas. I commend the amendment in the name of the Sinn Féin Deputies. The motion in the name of the Fianna Fáil Deputies has no credibility. Fianna Fáil was the party that imposed cut after cut to the health services, closing not only services but effectively closing hospitals. I know this only too well.

This debate was prompted by the €130 million in further cuts announced by the HSE on 30 August. This reduction was on top of the over €750 million taken out of the health services in budget 2012. This followed a cut of €1 billion, taken from the health budget for 2011. Among the cuts announced on 30 August were further restrictions on overtime and the use of agency staff. Additional overtime and the hiring of agency staff were made necessary by the ongoing recruitment ban. Despite their vocal opposition to it prior to the general election, the Minister and his Fine Gael and Labour colleagues have not lifted that ban. This is a very important and central issue in our considerations. We warned that such cuts would compromise front-line services, and this is exactly what is happening now. That is the reality in which we are today.

The lead clinician in the department of anaesthesia at Our Lady of Lourdes Hospital, Drogheda, Dr. Michael Staunton, makes clear in a letter sent to the HSE in the past week that the cuts will have a very serious effect on the intensive care unit and operating theatres in his hospital. In both cases, services will be significantly reduced for patients. Dr. Staunton states with authority that, among the list of effects, the cuts may have the effect of "increased morbidity and mortality of critically ill patients". The cuts in the hospital in Drogheda will mean the closure of 16 inpatient beds, one operating theatre for five to six weeks, day ward beds at night and at weekends and one intensive care unit bed. They will mean reduced opening hours for the acute medical assessment unit and the closure of beds in Louth County Hospital, Dundalk, for clinically discharged patients from Our Lady of Lourdes Hospital. This is but one example of the impact of the further proposed cuts on one hospital. It is replicated at other hospitals in the north east and, undoubtedly, it will reveal itself in hospitals throughout the jurisdiction.

Our Lady of Lourdes Hospital is the main acute hospital in the north-east region, covering counties Louth, Meath, Cavan and Monaghan and also accepting many patients from Dublin North, the Minister's constituency. The implementation of the cuts would put the lives and health of people in the region at risk. I demand on behalf of all those who are and will be affected by these cuts that the Minister intervene and ensure the cuts are stopped, and stopped now. I refer to but one region but the reality of savage health cuts is replicated across all HSE regions. I warrant that what has been exposed in regard to the Louth-Meath hospital group will expose itself in a very short period in various HSE areas across the State.

Since and before the Minister took office, he made great play of his determination to take the reins in his own hands and take executive responsibility back to his office from the HSE. He legislated accordingly, which I supported and welcomed at the time because I believe this is how it should be. However, with respect, we must ask where the Minister was when the cuts amounting to €130 million were announced on 30 August. He left it to the HSE to be the bearer of bad news. He was nowhere to be seen on that day and he had to be smoked out of hiding to answer to the media and the public. What an announcement it was. One should make no mistake: home care packages and home help hours were cut. There were cuts in respect of agencies and overtime and no lifting of the recruitment ban. Personal assistance for the disabled was cut. It was truly appalling and the impact was incredible.

I commend the people with disabilities, who deserve to be recognised and commended tonight. They camped outside Government Buildings. It is terrible to think back on what they had to undertake. They demanded the lifting of the cuts affecting personal assistants. They secured what I can only describe, as generously as I can, as an apparent climb-down by the Government. We must wait and see how that works out in practice. It is not crystal-clear at all.

What I want to ask this Cabinet is how such a cruel cut was approved in the first place. Are we expected to believe that this was not approved directly by the Minister? Are we to believe that the detail of this major package of €130 million in further cuts in public health services did not cross his desk? If it did not cross his desk, the claim that he is a hands-on Minister who has taken the reins from the HSE is spurious. If he signed off on these cuts, he bears responsibility for causing distress to the most vulnerable of our citizens. That he must climb down in the space of but one week shows what can only be called chaotic management of our public health services.

Unquestionably, the Minister for Health, Deputy Reilly, and his Fine Gael Party and Labour Party Cabinet colleagues are plunging the health services into an ever deep crisis with the savage cuts being imposed. These are not the words of Opposition voices only or those shared with him privately by voices in the House. These are the views of lead clinicians at hospital sites the length and breadth of the country. This real and genuine concern is growing to angry proportions.

Incredibly, the Minister has claimed that the health cuts in budget 2012 did not lead to a loss of services despite the fact that hospital and nursing home beds have been closed and services reduced across the hospital system. Surely we all recognise the fact that existing home help, home care and personal assistant services are insufficient to meet current needs, yet they are to be reduced further. The HSE and the Government are also slashing the numbers of public nursing home beds and claiming that the priority is to keep older people living in their own homes. I have had some personal experience of this issue recently. It poses a dreadful challenge to families. The necessary level of support does not exist to achieve an objective that is shared across this House, namely, allowing older people in infirmity and suffering progressive deterioration, for example, from Alzheimer's disease and a range of other challenges, to stay in their own homes as they desire. This difficulty is presenting for many families the length and breadth of the country.

These supports are critical in our efforts to try to keep older people living in their own homes, yet approximately 300 public nursing home beds have been closed this year so far. It is estimated that 600 mostly older people are in hospital beds and ready to be discharged but awaiting non-existent care places. Some 2,400 public acute hospital beds are closed.

We had the further revelation in the past week that the promised provision of free general practitioner, GP, care to people on the long-term illness scheme may be delayed for a further 12 months. The extension of free GP care to all, beginning with people on the long-term illness scheme, was supposed to be a cornerstone of the Fine Gael-Labour parties' coalition health reforms. Free GP care for long-term illness patients was promised by the Minister for 2012. So much for his promises. Legal issues are being cited for the delay. If this is the case, it is incredible that it took more than a year in government for the alleged legal difficulty to come to light, given the fact that the commitment to start the roll-out of free GP was a Fine Gael Party and Labour Party promise from long before the February 2011 general election. Many will suspect that the alleged legal difficulty is a convenient excuse to cover a retreat brought about by the financial crisis in the health sector, a crisis worsened by the Government's policies. If there is a real legal difficulty, the whole basis of the promised reforms of the Minister and his coalition colleagues is in question and they must be challenged on their failure to provide a proper legislative foundation for those reforms.

The spending over-run in the health budget this year was utterly predictable because the amount of money cut from the health budget for 2012 was unsustainable. Some €750 million was taken out of health in the Fine Gael-Labour Government's 2012 budget.

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