Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

I welcome the opportunity to speak on this Private Members' motion. I thank my colleague, Deputy Kelleher, for tabling this motion, which is very timely in view of the difficulties that are happening on a daily basis. The public at large is aware of the difficulties people experience when they have to interact with hospital services because it sees them on television screens and hears about them from family members, friends, neighbours and relations.

Our motion is very clearcut and direct. It is not long-winded. It is concise and to the point. It notes "the deplorable overcrowding being experienced in hospital emergency departments". We all know that the number of people waiting on trolleys exceeded 600 last week. The most depressing aspect of this matter is that these problems were foreseeable, as the Minister has admitted. He took some action in advance to make sure we would not have this crisis. His predecessor as Minister for Health, Deputy Reilly, said that any Minister who had more than 550 people waiting on trolleys would be facing a crisis. That is what we have today. We have had it for the last number of weeks. There might be some change from week to week, but the essence of the problem is still there. We need to talk about the underlying issues that are not being dealt with.

When I think about the number of people waiting on trolleys, the most depressing aspect of it is that many people cannot get from ambulances into accident and emergency departments because those departments are chock-a-block. Some Deputies have already spoken about this. Both sides of hospital corridors are full of trolleys that are being laid head-to-head or head-to-toe. Many people have had to wait in ambulances because of a lack of room. On some occasions, the ambulance trolleys on which people were brought in from ambulances by emergency technicians were left in hospitals because ambulance staff were not able to get those trolleys back when they were called out after their ambulances received subsequent emergency calls. Now they are holding on to the patient in the ambulance in the car park, rather than letting go of the actual trolley. That is a Third World way of doing business, if not a fourth or fifth world way of doing business. People must ask themselves if this is what we have actually come to.

The most important aspect of all of this relates to the many people who had scheduled hospital appointments. I can think of many elderly people who had appointments cancelled last October or November. In the wind-up towards the end of the year, hospitals that had reached their annual quotas for orthopaedic operations, for example, by September or October scaled down their levels of activity. Many surgeons were not fully occupied because sufficient resources were not available to provide additional nursing care in post-operative situations. The operations that were not being carried out were delayed until the new year. Many people are now finding in January, having got psyched up and ready for their operations, that their procedures are not going to proceed because elective surgery has been suspended in many cases. That is unnecessarily causing further distress and anxiety to older people. As a result, hospital treatments are increasing.

I was concerned to read at the weekend that some consultants are not willing to take on new patients because their waiting lists are full and those on the lists are having to wait for excessive periods of time. They believe it would be unsafe to add anyone else to the end of those lists because they would not be seen within a reasonable time. People who need to be taken onto consultants' waiting lists are not getting onto those lists. This is another element of what is not being counted in the health service. I suggest that the Minister and all his officials do not yet have a proper handle on the number of people who are waiting for outpatients' appointments and elective surgery. Some of those who are waiting are not being taken onto consultants' waiting lists even though they need to be seen. They are somewhere in limbo in the system.

The clinical risk to patients is a very serious issue. The Taoiseach said here in the Dáil today that "accident and emergency departments were not as safe as they ought to have been". Even though he did not say it in so many words, it is clear he was saying that accident and emergency units are not up to the acceptable standards that HIQA would want in such units. The Taoiseach acknowledged that here today. That is no recommendation to be giving the hospital service and the HSE in how they conduct their business. It is due to a lack of funding. Why is there a lack of funding for the HSE? The Government chose not to give adequate funding to the health services. It decided to use its resources in other ways. I will come to that in a few minutes.

I would like to speak briefly about the question of dignity on trolleys. I have seen elderly people - in their 70s and 80s and even older - being treated head to toe along the side of a corridor. I have seen young children in the corridor waiting to get into the same accident and emergency department. There is sometimes no dignity in the manner in which they are treated. There is no privacy when nurses come to them to check their blood pressure and see how they are doing, or when doctors come to do various tests at the side of a corridor. It is enormously upsetting for elderly people. They ask whether this is what they have come to at the end of their days. They ask whether this is really happening to them, having reared their families and worked for many years.

I mentioned in this House two months ago that I saw this happening in Naas General Hospital when I happened to be there on a few occasions in November of last year. On one particular day, the nurses took to the street at lunchtime to protest against the queues in the accident and emergency department. I stress that they did this on their own time. They wanted to highlight difficulties with patient safety. A further aspect of this issue was evident outside Leinster House today when we were met by nurses on our first day back in the Dáil. They were not speaking for themselves. They were not out looking for pay rises, roster changes or improvements in terms and conditions. They were speaking up for their patients. The families of patients are probably afraid to upset the doctors and nurses who are struggling to the best of their ability in accident and emergency departments.

Families can be slow to speak up in such situations.

Accident and emergency staff have a tremendous responsibility, but many are overstretched and are being put in an impossible situation. We must ask ourselves why. The reason is simple: we have 2,000 fewer beds in the system. One cannot remove 2,000 beds over a number of years and expect the system to function as normal. This has led to the inevitable consequence of there being a backlog in accident and emergency departments. As has been stated, there are also delays in the fair deal scheme. It is extraordinary that the Minister keeps referring to the cap on its budget as if someone somewhere capped it. He is the Minister. He capped the budget. He cannot blame the Minister for Public Expenditure and Reform, Deputy Howlin, or the rest of the Government.

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