Colm Keaveney (Galway East, Fianna Fail) | Oireachtas source

I am glad the Ceann Comhairle is in the Chair tonight because I want to publicly acknowledge his kind written words to my family with respect to the passing of my brother, Kieran. The Ceann Comhairle has had a difficult day, or at least attempts in that regard were made by some, but I want to acknowledge his commitment to being the father of this House and the good work he does behind the scenes.

The Minister for Health recently engaged in a PR stunt by going out with an ambulance crew on a shift. In fairness, it generated some positive focus on the ambulance crew and the Minister probably got some kudos out of it for himself. However, the people who are dependent on the ambulance service require him to be less focused on PR stunts, to get behind the desk of his new Ministry and to start dealing with the problems that are coming up every day within the health service.

One of those problems is the state of the national ambulance service.

HIQA recently published a report which explicitly says: "[I]t is of significant concern to the Authority that the well known ambulance 'black spot' areas of Tuam Co Galway, Mulranny Co Mayo and Loughglynn Co Roscommon remain without a dedicated ambulance resource." The report also says that at the time of review there were no staff at Mulranny and Tuam and there was occasional movement of an ambulance between Tuam and Roscommon, serving both locations. It is a damning review that states that if we do not properly resource these areas and address any deficits, we are astray with regard to the national ambulance strategy. It should be a concern to everybody where I live, because the HSE has failed to act with regard to emergency response times.

I am asking the Minister to pay particular attention to the black spot in Tuam. I appreciate that I am here to represent my constituency, but I ask the Minister to remember that the absence of investment in the 11 EMTs identified by Deputy Kitt is essentially playing Russian roulette with my community, because the closest response time is 62 minutes from Galway city. This is completely out of sync with regard to adequate or acceptable response times. The Minister was canvassing in the by-election in Roscommon, as was I. The people there are as angry as the people of Tuam with regard to commitments for the delivery of health services. I ask the Minister to pay attention to the commitment to open that ambulance base in Tuam and to be more honourable than the Taoiseach was when he stood in front of the people of Roscommon with regard to the commitments he made. I ask the Minister to pull back from the preliminary rounds of Fine Gael's leadership battle and to focus strictly on his job, because I think he could do a good job in health if he was less obsessed with taking out the Taoiseach and focused more on the role of Minister.

I will now move on to mental health. As the Minister is aware, an additional commitment of €35 million is ring-fenced this year as part of the programme for Government to provide for the roll-out of specialist staff for community-led psychiatric teams. The Government has consistently failed to honour that commitment since 2011. In fact, we should have expected €50 million in ring-fenced and focused investment in light of the fact that the Minister of State, Deputy Kathleen Lynch, capitulated and let the former Minister for Health pickpocket her in the 2014 service plan. This has consistently undermined the roll-out of A Vision of Change. The Minister of State has abjectly failed. The only consistency she has managed to maintain since 2011 is her failure to protect her budget. The fact that she has failed to protect her budget means that she has failed to deliver on the service plan. This year, only a small quantum of the €20 million in additional funding provided for mental health staffing is being invested. This is a consequence of the deliberate situation designed last year whereby staff provided for in the service plan in 2014 were time-delayed. The service plan provided for 200 staff last year but not one of them is currently in situand we are now in December. This is the tactic that people out there are seeing through. I accept that there is a cynical approach with regard to the hiring of staff. I now know that it has been designed to ensure that it came at the end of the year, but mental health and mental illness do not wait for budgets, time delays and deliberate manipulation of the budget to ensure its effect is maximised. I ask the Minister of State to speak to stakeholders and look at the impact of these decisions, because I have a sense that she is surrounding herself with and hand-picking managers who offer advice she wants to hear. The Minister of State is opposed to any sort of critical analysis with regard to the roll-out of A Vision for Change. She does not listen to the front-line staff. I ask the Minister to listen to the words of Dr. Shari McDaid, director of mental health reform. She has said that the HSE's ability to provide people in mental and emotional distress with the support they need depends on the presence of skilled staff, and that services will not run 24-7 because crisis intervention support is simply not there. She went on to say that while more than 700 staff have been recruited into mental health services since 2011, there are still only 90 additional posts in light of the fact that natural wastage, redundancy and retirement have been the opportunities the Minister of State has used with regard to further recruitment. She has spoken about how the HSE service plan commits to building capacity for mental health services to respond 24 hours a day to people in a crisis. This is pushing it out there until the latter part of 2015, which is a concern for the stakeholders. In particular, I ask the Minister of State to sit down and talk to the service users and front-line staff in respect of the roll-out of the subsequent aspects of A Vision for Change.

The Disability Federation of Ireland, DPI, welcomed the additional €20 million provided for in the service plan. However, as we sit here today, the Minister is taking money from the Brothers of Charity and Ability West. John Dolan, CEO of DPI, stated that it is a demand-led service and that it continues to draw out money in light of the fact that one person a week sustains a spinal cord injury. He also said that we are seeing increasing numbers entering the service and that with only €20 million the service is running to stand still. He stated: "The HSE Service Plan talks about disability services moving towards new models of service delivery that enable people with disabilities to participate in a meaningful way in their own communities." Talking in general about the service plan, Mr Dolan stated:

The health system is deteriorating at a worrying rate. Ireland’s population is increasing, people are living longer, waiting lists are drastically increasing and there are worrying levels of unmet need. Those providing health services simply don't have the resources required to deliver to an acceptable standard.

I am entirely in agreement with Mr Dolan. I think we should all work together to focus on his concerns. Health desperately needs adequate funding. It is demand-led. I know the Minister is honest and can identify the issues, but he needs to stay with them.We need to work together to find solutions for these issues because we have a mutual interest in the health of this country. We cannot approach the health service in the same way we approached the last budget, whereby we set out essentially to buy votes with tax cuts. We need to learn lessons of the decisions of the past, as I was elected to do. We need to be honest about budgeting and to have a proper framework on how we budget for the health service. The Minister will have support from this side of the House if he is prepared to be transparent, honest and realistic with regard to those budgets. People within the health service are alarmed at the deteriorating conditions in which they are working. It is becoming patently clear to the public that the public health service is in crisis. It is no wonder we hear that everything is dandy in the mental health service, as the Minister of State said last week. There were no problems. She went out and allegedly listened to front-line staff. Like Catherine the Great, she allows herself to be presented with Potemkin villages. I ask the Minister to speak to the Minister of State so that she gets out of that bubble of senior managers, advisers and experts around her and listens to the experiences of service users and front-line staff and, for once, gets an honest opinion about what is happening rather than listening to people who tell her what she wants to hear.

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