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

The HSE national service plan for 2015 was published on 27 November following approval by the Minister for Health, Deputy Leo Varadkar. The service plan lays out the type and level of services that the HSE is to provide both directly and through agencies funded by it. The Fianna Fáil motion before the House focuses on this plan. In doing so, it focuses on one of the most important roles of government - providing appropriate, accessible health services. These are the services that we, as citizens, need right from our birth and throughout all our lives. Citizens are entitled to health services of a high quality and that respond to their needs. Good health is something we only fully appreciate when we no longer have it. Those who are sick and those with sick children and other family members are all too aware of the many difficulties facing this health system. Any parent would do anything within their power to ensure their child has the best care that will give them the best possible chance in life. Under our current system, there are so many examples of chronically under-funded and under-provided services. There are, sadly, so many areas in which sick children and adults are not given a chance at a healthy future. This must change but it appears, unfortunately, this is not a short-term priority for the current Government.

Dar le rún Fhianna Fáil rinneadh maoiniú ró-íseal ar an gcóras sláinte. Is rud é seo gur féidir linn aontú air. Tar éis gur thosaigh Fianna Fáil na ciorruithe, choinnigh Fine Gael agus Páirtí an Lucht Oibre orthu ag ciorrú caiteachais atá riachtanach don tsláinte. D’fhág sin sa riocht seo ina bhfuilimid anois.

The motion states, “the 2015 Health Service Executive National Service Plan is not sufficient to fully address the increasing demands and demographic pressures being placed on our hospital system”. This is a point I have made on several occasions over recent years, including when Fianna Fáil was in power. I feel that this oft-repeated fact will once again fall on deaf ears. There appears, again sadly, to be little recognition from the current Minister and the Government team that population demands on the service are increasing and need to be met.

The motion then reads: “key targets in the Plan are regarded as unrealistic by its authors.” This is true. Authors of the plan itself recognise that some of its key targets are unrealistic. This is an indictment of the Health Service Executive and of the Government, in particular, regarding the manner in which plans are drawn up and promises are made when they know full well they will be unable to deliver on many of them. This recognition by the authors can be seen in the following passage from the service plan: “After many years of significant financial reductions, this additional resource will assist in the allocation of more realistic budgets enabling the health services to maintain the current levels of services.” Some hope in 2015, I fear. Fianna Fáil calls “on the Government to fund the health services appropriately and sufficiently in 2015”, something, of course, it failed to do during its later years of opportunity.

I have previously described the HSE national service plan as wholly inadequate. There are now 50,000 outpatients on waiting lists for more than a year. There is nothing in this so-called national service plan that reassures me that these numbers can be significantly reduced in the short term. The fair deal continues to be under-provided for, leading to families stretched to breaking point and delayed discharges, yet this plan only offers the already announced €25 million. An extra 300 nursing home places will be provided for next year but there are currently 2,000 people who have been medically assessed as needing nursing home care and who are awaiting fair deal payment.

The minor increase in numbers of doctors and nurses is undoubtedly necessary but the numbers mentioned only go a very small way towards addressing some of the most savage cuts in staff numbers in recent years. I note there are many unfilled GP places at present, including in my own constituency, with our qualified doctors opting to work abroad in many instances. This exodus, apart from the tragedy of it, is extremely expensive as it means we lose graduates who have received heavy State investment throughout their education.

Many of the positive measures in the plan were already announced before the plan was presented. I have welcomed the additional €20 million funding for disability services but this is only a drop in the ocean. In Sinn Féin’s alternative budget, we would have provided an additional €31 million for these services, openly acknowledging, as I did, that even that would not be enough due to years of severe under-funding. Some €25 million is allocated for free GP care for children under six years of age, yet we still are not sure whether there will be a so-called "nominal" charge by GPs for this care. Will the Minister of State, Deputy Lynch, update us on this point?

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