Barry Cowen (Laois-Offaly, Fianna Fail) | Oireachtas source

The motion states categorically and plainly, as has been said by my colleagues, that the 2014 national service plan of the HSE is inadequate to meet fully all the growing demands placed on the health services. The lack of sufficient resources will not be in the best interests of patient care. This service plan provides for fewer people to be treated as inpatients, fewer people to be treated as outpatients and fewer people to be treated as day cases in hospitals throughout the country this year. The service plan means that far fewer people will have medical cards by the end of 2014.

Let us consider the discussion on the service plan that took place at the Oireachtas Joint Committee on Health and Children earlier this month. It was interesting to hear members of the HSE outline a series of measures that do not necessarily have a significant cost but are none the less absent from this service plan. They said they would like to have developed a national perinatal pathology service at a cost of €420,000 this year but they are not in a position to do so. They would like to have seen phase 2 of the intermediary care service at a cost of €4.4 million but they will not be doing that this year. They said they would like to have done more in the area of health and well-being initiatives at a cost of €1.5 million but will not be doing so. They were keen to roll out an extension of BreastCheck at a cost of €500,000 in the current year but they will not be proceeding with that. Nor could the HSE or the Minister secure Government resources for a €40 million proposal that would review home care and community support services, develop a new model of service delivery and maintain home help hours at 2013 levels despite the cuts. The proposal would provide home care packages and support for early discharge from hospital while reducing the level of entry to long-term residential care, but this will not materialise. They could not get an extra €25 million to meet the increased demand for dental treatment services and stop the growing loss of dental treatment services through the country and at various locations in my constituency.

One of the previous speakers quoted what the HSE chief executive, Tony O'Brien, had to say before a Cabinet meeting at Christmas. He said, "It will not be possible to fully meet all of the growing demands being placed on the health services".

After the meeting, however, the spin was in overdrive, with Mr. O'Brien stating that it would merely be "very challenging" in 2014 to meet all of the growing demands on services.

Colleagues have dealt with the pressures on hospital emergency departments. Will the Minister clarify what is happening in regard to the fair deal scheme and offer assurances regarding the issues we have outlined in this regard? Age Action Ireland has expressed concern about the impact the service plan will have on the sickest and most vulnerable, including older people. The plan acknowledges that waiting times for a nursing home bed under the fair deal scheme will increase in 2014. In fact, it states that 700 fewer beds will be funded under the scheme this year compared with the target for 2013.

Deputy Colm Keaveney outlined the issues arising in the area of mental health services provision, including the frustration on the part of patients that the delivery of the promised funding for 2013 and 2014 will be subject to delays. Deputy John Browne referred to the situation in the regions, where health service managers have a right to know the true extent of the cuts proposed in the 2014 plan. I understand the Midland Regional Hospital in Tullamore and the hospitals in Mullingar and Portlaoise have started the year in the dark in this regard. Will the Minister not do the honest and decent thing by publishing the full plan without further delay? We need to know what the full and real effect will be in terms of the ability of health service providers throughout the regions to deliver front-line services.

Deputy Browne mentioned the consternation that has been expressed in regard to ambulance services in Wexford. Similar concerns arise in respect of the service in Offaly, Donegal and throughout the country, as we have heard from various Deputies in recent weeks. The reconfiguration of staff and of moneys serves only to re-emphasise the fact that moving the deck chairs around does not address the underlying issue. If the risks associated with the policy of cuts and efficiencies are not addressed, there will be obvious and unfortunate consequences for ambulance services throughout the country.

The failure on the part of the Minister to provide adequate time for a debate of this magnitude has put paid to the prospect of the representatives of the people in this House obtaining a fair and adequate explanation of the situation as it stands and as proposed for 2014 in the context of the proposed service plan for the health services.

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