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

A cháirde, cuireann sé an-díomá orm mar urlabhraí Shinn Féin maidir le cursaí sláinte go bhfuil an cheist seo á phlé againn arís. Theip ar gach aon dream a bhí sa Rialtas le deich mbliana anuas aghaidh a thabhairt air nó aon réiteach a fháil. Tá ag teip ar an Aire, Teachta Varadkar, chomh maith.

Last week saw the highest number on trolleys ever recorded, with the number reaching as high as 601 at the start of the week. Beaumont Hospital and Our Lady of Lourdes Hospital in Drogheda were among the worst affected. While the figures have decreased somewhat this week, the system still has to deal with the 359 persons who are on trolleys today. Hospitals could be put under further significant pressure by weather conditions or an increase in seasonal illness. Were we to see icy conditions across the country, I fear accidents might swamp our already understaffed and under-resourced accident and emergency network.

The Minister, Deputy Varadkar, was nowhere to be seen, let alone heard, while the crisis developed. We eventually learned – some of his colleagues did not offer the explanation – that he had been on holiday. This is his due but, following his return, he attempted to wash his hands of the situation, saying he could not magically press a button in the Department to fix the crisis. As Minister, he must take responsibility. If there is resistance to change, the onus is on him to tackle it. We need to know that solutions are being applied and what they are. We do not want to hear why the Minister believes certain things cannot be done. It was not very long ago that the Taoiseach admonished the Minister for this.

The rate of presentation at accident and emergency departments has increased. We know that health systems experience high demand during the winter, and also that some people choose to attend their local emergency department instead of their general practitioner for the treatment of minor illnesses, but we have an increasing population and our health staff are seeing many more older and sicker patients. This was foreseeable. In fact, the Minister told us that he foresaw it but, despite this prescience, he was unable or unwilling to do anything to deal with the problem before it developed.

The numbers on trolleys increased this year for several reasons. Reduced numbers of step-down beds and poor provision for elderly patients fit to be discharged to alternative settings were chief among them. There are upwards of 800 patients whose acute care is finished but who have not been discharged into more appropriate step-down care settings. There are a shocking 2,135 people on the national placement list awaiting funding, with an average waiting time of 15 weeks.

There is a lack of capacity both in acute hospitals and step-down facilities and also across the long-term residential care sector. There is a crisis in staffing. There are currently 265 nursing post vacancies. The HSE is finding it difficult to recruit staff due to a lack of permanent contracts, the lack of certainty and the strain on nursing and medical staff in accident and emergency settings. Since the Minister refuses to ensure adequate staff, we will see a further exodus of staff from this section of the health service. This is a vicious circle.

A further problem is that many medical staff are non-senior, leaving accident and emergency departments lacking in senior decision-makers. The €25 million the HSE secured in the budget to address delayed discharges was a quarter of what it had requested. The Minister has convened emergency department taskforce meetings. When he was asked why the emergency department taskforce had not worked, he said, "I don't know". This is not good enough. As Minister, he cannot simply say he does not know and hope the problem will go away.

Other jurisdictions have also been under pressure in accident and emergency departments. The problem is not unique to us and many have experienced increased waiting times. We must remember, however, that in the neighbouring part of our island, the Six Counties, the target is four hours – a target that would be fanciful thinking regarding many accident and emergency departments in this State.

Earlier today, I commended nurses for their brave stand against the Minister's lack of action on the hospital overcrowding crisis. The Irish Nurses and Midwives Organisation organised a protest outside the Dáil today in a further effort to force the Minister to act.

It is an indictment of the current Minister's failure to deal with the crisis that nurses felt compelled to take to the streets. Through his cavalier attitude he has been grossly insensitive to all patients who have suffered the indignity and danger of long waits on trolleys. However, it is not only to him that I level such an accusation. We also saw Deputy Martin attend the protest today, so bold as to have forgotten his own role as Minister for Health and Children when he failed to address this problem, and the role of his party in the economic ruin of this country, with the cutbacks that followed leading, in part, to the current crisis.

I support all the hardworking and conscientious nurses who protested in the cold today and also their hardworking colleagues in hospitals across the country. They are demanding action and we in Sinn Féin support this demand.

It has been suggested by some commentators that Sinn Féin have said that this crisis was caused by austerity alone. I wish to dismiss that outright; it is not the case. We understand this has been a perennial problem, one that occurred even when the health system was relatively awash with money. It has, however, been magnified by staff redundancies and ward closures that have been visited on our hospital sites. What can be done? There are a number of measures that need to be taken and solutions that need to be applied but, sadly, the Minister appears to refuse to examine most of them. The HSE had sought €106.5 million to free up hospital beds and reduce overcrowding, of which only €25 million was granted. Despite record numbers awaiting appropriate placements, the Minister has not requested additional funds to deal with the problem. Additional funds are needed to support an adequate number of home care packages and for the re-commissioning of wards and the provision of the required additional step-down beds to assist in discharging the some 800 elderly patients in pre-discharge beds.

We need an attractive recruitment campaign to bring nurses back to Ireland to alleviate under-staffing. We also need to plan for the significant challenges of an ageing population, including long-term residential care requirements.

The emergency department task force should meet regularly until this crisis is successfully addressed, and it must also ensure that a system is in place to meet the problem head-on before it reoccurs.

Consultants, the senior decision makers, must ensure that they are present to help ease admission, fast-track treatment and discharge when appropriate. I welcome the fact that Mr. Liam Doran has been appointed co-chair of the emergency department task force. The task force's scope must be wide enough to examine structural reform to avoid the problem in the future.

Delays in funding house adaptations, lack of sufficient home-help packages and home-help cuts of 2.3 million hours since 2008 all have added further pressure on the entry points to the acute hospitals. Irish Nurses and Midwives Organisation, INMO, members at Naas General Hospital, Limerick University Hospital, Ennis, Nenagh and Croom all have voted for action. We must remember that they will continue to provide clinical care and all possible supports for patients. Their decisions are in the vein of trying to make the Minister pay heed to their concerns as front-line professionals.

The Joint Committee on Health and Children is to receive the Minister, Deputy Varadkar, tomorrow and I hope he will be able to tell us that the number on trolleys is again decreasing. If this turns out to be the case-----

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