Sandra McLellan (Cork East, Sinn Fein) | Oireachtas source

I welcome the opportunity of this Private Members' motion to address the situation in our public health service and the total inadequacy of this Government's budget for health and of the HSE's 2014 service plan. Sinn Féin will support the motion in the name of the Fianna Fáil Deputies as far as it goes. We agree, as the motion states, that the 2014 national service plan of the HSE is inadequate to fully meet all of the growing demands being placed on the health service. We also agree that the lack of sufficient resources will not be in the best interests of patient care and that this is already evident in accident and emergency departments.

That said, we are disappointed the motion does not go further. It makes no demands on the Government and puts forward no proposals for improvement and for the fundamental change, which is needed. This is disappointing but not surprising given that it was the Fianna Fáil leader, Deputy Martin, as Minister for Health, who set up the HSE in the first place. He maintained the unequal two-tier health system with its top heavy bureaucracy and its inequitable delivery of services both in terms of the public private division and in terms of regional disparities.

The current Fine Gael-Labour Party Government and the Minister for Health have talked much about reform but with little result. The reality has been that they have continued with the year-on-year cuts to our public health service which were begun by the last Fianna Fáil-led Government. A number of our Deputies have requested meetings with clinical directors in their areas to discuss the impacts of the health service cuts but some have been very slow to in coming forward to facilitate these meetings. For elected Deputies that is not good enough.

As I pointed out at the Select Committee on Health and Children today when we were dealing with the Revised Estimates for health, by the end of 2014, under the HSE's service plan, almost €4 billion will have been taken out of our public health service since 2008. In terms of staff numbers, a further 2,600 whole-time equivalents are to go in 2014 on top of the 12,500 which have gone since 2007. As the HSE admitted in the suppressed memo to Cabinet in advance of publication of the HSE service plan, the cuts being imposed in 2014 are unsustainable.

The statement earlier this month by the Irish Emergency Medicine Trainees Association that overcrowding in hospital emergency Departments is unequivocally dangerous for patients is a wake-up call for the Government. The trainees pointed out that over the previous two weeks, trolley numbers had exceeded 300 per day, and this came after the Irish Nurses and Midwives Organisation highlighted the increase in trolley figures in 2013 over the previous year.

The health cuts imposed by this Government, and reflected in the HSE service plan, are set to make the situation worse over the course of 2014. Hospitals are under severe pressure and the bed shortage is acute. This is compounded by the decision not to provide additional funding in the service plan for nursing home places, leading to more older people occupying acute hospital beds for longer as they await ever-scarcer nursing home places.

Under the heading of care of older people and community care, the Fine Gael-Labour Party programme for Government states:

Investment in the supply of more and better care for older people in the community and in residential settings will be a priority of this Government. Additional funding will be provided each year for the care of older people. This funding will go to more residential places, more home care packages and the delivery of more home help and other professional community care services.

This Government is clearly reneging on its commitment in its programme for Government to ensure the supply of more residential places for older people who need them. By its failure to live up to its own commitments, the Government is condemning older people, especially those with dementia, and their families to the misery of long stays in our public hospitals as they await nursing home places. This is first and foremost a terrible ordeal for those older people. Crucially, given the crisis in our hospitals, it means that acute hospital beds are being occupied by people who need long-term residential care and not long-term acute hospital care.

The first State-wide audit of dementia care carried out by Dr. Suzanne Timmons, consultant geriatrician at UCC Mercy Hospital, has just been published. It shows that one quarter of inpatients in our hospitals are affected by dementia. That is a huge percentage. The audit also shows that our health system is ill-equipped to deal with dementia. I cited this at the Select Committee on Health and Children today and I stress it again. The figures in the audit show that 91% of hospital wards have no access to psychology services while more than one third of wards have unfilled health care assistant vacancies. Dr. Timmons stated that the low standard of dementia care in hospitals continues to affect the overall well-being of patients. She also stated that for a person with dementia, it must be much more challenging and frightening and that if one is used to being at home with someone one recognises and is used to one's own routine, the acute hospital must be a very frightening place and that is why everyone who works in a hospital needs to improve their practices.

This will be growing problems which will need to be addressed but clearly Government policy is going in the opposite direction, as the service plan confirms. I urge the Government to change direction on the care of dementia, which is affecting increasing numbers of people as our population lives longer.

I want to take the opportunity presented to me by this health care debate to raise the imminent closure of Mount Carmel Hospital in Dublin. This hospital is being allowed to close with hardly a murmur from the Minister for Health. While it is privately owned, we have been told by the Irish Nurses and Midwives Organisation that at the time of last week's shock closure announcement, some 80% of the hospital's patients had been referred directly to it by the HSE from our public hospitals. Mount Carmel Hospital is not simply a private maternity hospital, as reported in the media. It has been providing a wide range of services and taking pressure from hard-pressed public hospitals. We are talking about 130 beds and 330 staff - 200 of them nurses - being removed from our health system. Why is this happening? Is it the case that the owners of Mount Carmel Hospital petitioned the High Court for liquidation at the behest of NAMA because their loans are in NAMA? This requires more detailed address by the Dáil and a detailed response from the Minister. I hope the Ceann Comhairle will accede to the request of Deputies for a Topical Issue debate on this pressing matter tomorrow or on Thursday. If something is not done in the next few days, this health facility will close, 130 beds will be lost and 330 experienced, qualified and dedicated staff will lose their jobs.

I wish to say a little more about the service plan. It has to be said that despite the untiring efforts of health workers, our service is not fit for purpose. The cuts introduced by Fianna Fáil, the Labour Party and Fine Gael have devastated front-line care. Some €4 billion has been taken out of our health services since 2008, while our people continue to pay the enormous debts of bankers and financial speculators. Thousands of people, including seriously ill and disabled children, are facing the loss of their discretionary medical cards this year. Accident and emergency services in hospitals throughout the State are under threat. Funding for nursing home beds is being cut. The knock-on effect of this is to put pressure on hospital beds. Prescription charges have been trebled by a Minister who condemned them when he was in opposition. All of this sends a clear message to the sick, the disabled, the elderly and anybody else who depends on the health service that they are far less important to the Government than investors, speculators and the markets. This is a grave injustice. Any Government that persists with such a policy is morally bankrupt. Sinn Féin is telling the Government that health care is a basic right and that the health service must not be diminished any further. It is beyond time for radical changes in the Government's health policy. We need a change of direction and we need it now.

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