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

The Fine Gael-Labour Party Government is wedded to its futile economic strategy of austerity. This strategy, inherited from Fianna Fáil and the Green Party, is being pursued with gusto. It is not working, yet the Government persists with it. It has not learned the lesson that if one tries something and repeat it year on year and it fails again, one must try something else. Austerity is undermining public services in a manner not seen since the 1980s. Nowhere is this more acutely in evidence than in public health services. We have had successive years of spending cuts, culminating in €1 billion being taken out in 2011 and €750 million in the current year. The spending over-run in the health budget this year was entirely predictable because the amount of money cut from the health budget for 2011 and 2012 was completely unsustainable. We are seeing the outworking of this cut in shrinking services and ever greater hardship for those who use the health service. Every Member is aware of this fact. Last week, regrettably, Members belonging to both Fine Gael and the Labour Party voted down a Sinn Féin Private Members' motion that had sought the reversal of the disgraceful cuts to home help hours and home care packages. The Minister for Health, Deputy James Reilly, has presided over cuts of almost 1 million home help hours since he took office. By their vote last week Government Deputies fully endorsed these cuts. There is no other conclusion to be drawn. They may claim sympathy with the vulnerable individuals who are losing home help hours or being denied home care packages, but they are shedding crocodile tears. They have signed up to a vicious regime of cuts.

The vulnerable and the elderly are being attacked on two fronts. The cuts in home help hours and home care packages are hitting people living in their own homes. There are now drastic cuts to the numbers of public nursing home beds also. The facts are much worse than even I had assumed in the past 12 months. I have received a reply from the HSE to a parliamentary question stating that from January 2011 to August 2012, a total of 1,201 public nursing home beds have been closed. These include both long-term and short-stay beds, meaning that provision for both long-term care and respite care is affected. Service cuts mean that many older people will have no choice but to seek residential care which, increasingly, will be private care because, side by side with its cuts regime, the Government, like its Fianna Fáil predecessors, is a champion of privatisation. That is some record for the Minister for Health and the Government - nearly 1 million home help hours cut and over 1,200 public nursing home beds closed in the period since the general election of 2011. We have now reached a position where vital services are collapsing or are on the brink of collapse.

Last night I met representatives of two providers of care services for people with disabilities. Sunbeam, based in County Wicklow, provides both residential and day care services for 350 people. In 2012 alone its funding from the HSE has been cut by €798,000. KARE, based in Kildare, provides services for people with intellectual disabilities. In 2012 its funding has been cut by €840,000. These cuts are on top of the cuts made every year since the collapse of the economy. The cuts of recent years have amounted to 15%. In 2012 the rate is 3.7% alone. How do the cuts affect persons seeking these supports or services? Their most immediate effect is that new service users cannot be taken on and the waiting list is growing. I learned last night of a couple in their 70s who have been waiting many years for a place in care for their disabled son who is in his 50s. Because of the cuts they may never find a place for him. This disabled man is being denied a chance to lead a more fulfilled life and his parents are being denied a sharing of the care burden in their 70s, after a lifetime of caring for him. Now, in their twilight years, they face awful uncertainty and anxiety about what will become of him when their day is done. I have no doubt that this case is replicated in every county. That harrowing and stressful situation and fear of parents as they age about their special needs son or daughter must be a terrible drain on them.

As well as preventing the taking on of new service users, the cuts have hit respite care provision, as well as early intervention, transport and day services. All of the efficiencies demanded by the HSE have been achieved by these service providers, while staffing numbers, pay and non-pay costs have been cut to the bone. Those involved in this sector which include service users, families and service providers are literally living in dread of what faces them in budget 2013. The collapse of services has already begun and further cuts to funding for disability services will accelerate the process. I use the opportunity to appeal that no further cuts be directed at services for older people or people with disabilities. What has happened already is shameful and there can be no consideration or countenancing of further cuts in budget 2013. I appeal to Members opposite to use their special access to support the voices from the Opposition benches.

The Government, in particular the Minister for Health, constantly repeats the mantra that it wants people to be able to stay in their homes or be housed in community care settings rather than in outmoded and inappropriate congregated settings - another word for institutions. In the past people with intellectual disabilities were placed in institutions such as St. Ita's Hospital in Portrane. The sad news is that we are returning to those days. The service providers report that because of the cuts, community houses are becoming unsustainable in some cases. That is what austerity means in practice.

A further cut to funding for disability services in 2013 will most definitely be a cut too far and must be resisted by all voices in the Chamber.

A cornerstone of the Government's programme is supposedly fundamental reform of the health service. The programme for Government promised a White Paper on financing universal health insurance "early in the Government's first term". A Department of Health briefing for this morning's meeting of the Joint Committee on Health and Children, which I attended, states the White Paper will be published "as early as possible within the Government's term of office". Where stands this reform?

We have decreasing numbers of people with health insurance, rising premiums for those who have insurance, more pressure on the public health system from those exiting private health insurance and the persistence of a two-tier public-private system in which the struggling public system subsidises the private health sector. As I have repeatedly stated, Sinn Féin favours universal health care based on equal access for all. We want such a system to be provided by the State, funded from fair general taxation and free at the point of delivery. This would have to involve a higher contribution in tax from the highest earners than they currently contribute.

While we do not favour the model of insurance-based funding, if health insurance is to be the basis for funding, it should be a State insurance scheme. The least desirable model is an insurance system based on competing private health insurance companies. In such a scenario, the profit motive and interests of shareholders rather than the provision of a quality public health service for all citizens become the paramount consideration. The Government is pursuing the privatised insurance or Fine Gael model. The Labour Party, which had a different view from the Fine Gael Party on this matter, seems to have lost the argument in the negotiations on the programme for Government, assuming it raised the issue during that engagement. Taking the insurance route is a mistake. It offers the increasingly remote prospect of reform while the deeply flawed current two-tier system deteriorates, especially as a result of the austerity policy and health cuts of the Government.

Today the troika returns, and I have no doubt the Government will receive another pat on the head for its punishment of the people who elected it. However, there is another troika, one which does not come to Ireland on visits, namely, the combination of Fine Gael, the Labour Party and Fianna Fáil. Despite the bluster from Fianna Fáil Deputies, their party shares the same economic approach as the coalition. It is committed to austerity with all its fatal consequences for the economy and society. Its hallmark is hypocrisy, which it displays at every turn.

I was not the only republican who was deeply touched by the Fianna Fáil Party leader's new-found interest in social and economic affairs in the Six Counties, which he reflected on in Bodenstown last Sunday. No one was fooled, however, because his words were nothing more than a thin disguise for taking a swipe at Sinn Féin on the basis of opinion polls. There is no doubt the Fianna Fáil Party is increasingly attempting to insinuate itself back into communities. It still has cheerleaders in the media and, together with them, it is trying to foster collective amnesia in the hope that many will forget its appalling record in destroying the economy and exercising a deeply corrupting influence on politics. No one should forget any of this.

See this speech in context