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

Is deis é seo don Rialtas beagán den dochar mór atá déanta aige a athrú, ach ní dhearna sé sin. Tá siad ag díriú ar an dtoghchán ginearálta. Tá siad ag caint lena vótálaithe féin agus ag rá go bhfuil gach rud ceart go leor agus mar sin gur cóir coinneál leis an Rialtas seo. Ach mar is eol do mhadraí na sráide, níl gach rud ina cheart in aon chor.

This Spring Economic Statement represented an opportunity to ensure that critical areas of spending callously under-resourced by this Government were given a boost. It gave the Government a chance to restore funds to areas it had cut since 2011. Unfortunately the Government has simply used it to announce vague tax cuts and spending to butter up Fine Gael voters and any remaining Labour Party voters. The Government has missed a great chance to invest in our public services. In short, what has been announced is uninspired and uninspiring.

The Minister for Finance, Deputy Noonan has said that the Government will cut income tax and universal social charge rates. This must be directed to low and middle income earners but unfortunately, under the current Government, I would not be so sure that this will be the case. The devil, as always, will be in the detail. While we need to remove the regressive taxes our focus should be on the betterment of our public services for all rather than tax cuts for the rich. We ask for a fair recovery. Some on the other side of this house might ask "Why?" We do so because our society is intrinsically biased against those on low incomes. That is a fact. The cards are stacked against someone brought up in a deprived area and I and my party colleagues strongly believe that everyone should have the same opportunity in life. Everyone should have the same access to health care no matter where they are from or their economic circumstances. We know that poverty and ill health are linked. Life expectancy in this State is lower in the most deprived geographical areas, where for men it is 73.7 years compared to 78 years in the most affluent areas. According to The Lancetstudy of 2015, widening inequalities are evident by the time people reach adolescence.

Under this Government's watch our public health system's workforce has decreased by 8.7% whole-time equivalent staff. There has been a 29% reduction in public beds since 2008. The Government will say that it did not oversee all of this but rather than reversing these cruel cuts, it deepened them. From the time this Government took office until the end of 2014 there were 2,724 fewer nurses working in the HSE. The Minister for Public Expenditure and Reform, Deputy Howlin has said that the Government has appointed 1,000 nurses since 2014. If this is true, it is only an increase on a massively reduced base figure. Overall, under this Government there has been a reduction in nursing numbers, no matter what way the Minister tries to spin it. These cuts have been made despite the number of over 65s increasing by approximately 20,000 every year. We need structural change now to prepare for this increase. Home help hours have also reduced from a high of 12.64 million hours in 2008 to a current level of 10.3 million hours. What in this statement helps our older people stay at home?

We have had some announcements in recent weeks on GP care but this has only gone so far. Ireland's is the only EU health system that does not offer universal coverage of primary care. Why did the Government fail to outline how it would give free GP care to all in this Spring Economic Statement? It is because that it not its priority. It is content with a two-tier system that has further inbuilt two-tier discrimination. We now have more inequalities in our health service than when this Government came to office. This State spends less than the average on health and the public picks up the remainder in the form of out-of-pocket payments to GPs, private health insurance and other charges.

Roughly 60% of our population pay approximately €50 to visit the GP, when they can afford it. These expenses are recognised as a barrier to accessing appropriate medicine.

We were promised 530 primary care teams to be in place by 2011 but in 2014 only 419 were in place. How does the spring economic statement address this major shortfall?

What in this spring statement will address the 405,000 on waiting lists to be seen at outpatient clinics? In 2001 the health strategy set three months as a target for treatment after attendance at the outpatient department. In 2013 the target was set at one year to be seen first for specialist treatment. Now the so-called target has stretched to 18 months for 2015. When the Minister, Deputy Varadkar, realised the Government was unwilling to prioritise some of its sickest and most vulnerable citizens he simply moved the goalposts.

What measures in this spring statement will ensure that the scandal of 600 patients on trolleys will not happen again in 2016, the centenary of the Rising? A national emergency was declared in 2006 when just 495 patients were on trolleys. The Taoiseach promised to "end the scandal of patients on trolleys" during Fine Gael's 2007 election campaign. We saw 459 on trolleys yesterday.

At the end of 2014 there were 2,135 waiting for nursing home funding, waiting 15 weeks on average. This in turn puts pressure on the acute hospital system with many of these in delayed discharge situations. Why did the Government not decide to address fully the funding challenges of the fair deal scheme yesterday?

The Minister, Deputy Varadkar, has become something of a cheerleader for private health insurance. How do families, who cannot afford private health insurance but are deemed to be not poor enough to qualify for a medical card, feel when they hear the Minister champion a two-tier system? We know that private health insurance contributes only 7% to 10% to the overall health-related spend. We know that PHI is out of the grasp of many families across the State. The current media bombardment of the under-35s is a downright disgrace.

The Minister should stop the focus on propping up this two-tier system that thrives on discrimination and give serious consideration to the roll-out of free GP care for all citizens as a first step to the roll-out of universal health care. The Fine Gael election manifesto promised that charges for medications for those with medical cards would be abolished but decided instead to increase it from 50 cent to €2.50. This has been loaded on the poorest and sickest citizens and we know from surveys that 38% of medical card patients have second thoughts about filling a prescription because of the levy. International evidence bears out that cost acts as a barrier to purchasing prescribed medication.

Two of the largest pharmaceutical companies in the world, Pfizer and Teva, have now reportedly informed the State that they will not reduce the price of commonly prescribed medicines. This might leave hundreds of thousands of medical card patients open to co-payments from next weekend. The Government must set out to achieve the lowest possible price for medications for all medical card patients. Those with medical cards must not be simply used as pawns in this game. They cannot be left without medications or with the prospect of having to make co-payments. Darragh O'Loughlin, secretary general of the Irish Pharmacy Union, IPU, described this as "the start of co-payments for medical card patients." I certainly hope this is not the case, but how does the Government propose to address this?

What of the staffing of our mental health services, which in 2015 was at only 74% of what had been recommended in A Vision for Change? Will funding that had been ring-fenced and then un-ring-fenced by the Government now be spent in this most deserving and traditionally underfunded sector?

In summary, yesterday's spring economic statement was merely a rehash of what has already been announced. It does nothing to address the many problems I have outlined. The Minister, Deputy Howlin, outlined some vague proposals for investment but no concrete steps were even mentioned for our damaged health service. I do not believe many will be fooled by the Government's efforts to pull the wool over the eyes of the public once again. The dodging and diving has gone on for too long. The public will no longer put up with niceties about a recovery when the reality is very different for them. We need a fair recovery now and it seems that only Sinn Féin is willing or able to make that a reality.

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