Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

I welcome the conclusion of the Bill. I agree with everything the Minister of State has just said but, unfortunately, the reality on the ground is so different from what she is working towards. We have a general practitioner system that is in a fundamental crisis and has been for some time.

When one is not near an acute hospital, one uses one’s GP. I often remember the case 20 years ago of a visitor to Ballina asking where was the nearest acute general hospital. When I informed her it was an hour away in Castlebar, she nearly dropped. I then explained to her that we simply went to our GP. Now, however, we are struggling to get GPs in rural areas. Although it was once seen as a fantastic career, rural areas now cannot be guaranteed a GP service. Of course, in such instances, people will have to go to the hospital even if it is an hour and a half away. We have had instances of this in Bangor and Glenamoy recently.

While there are more pharmacies, we need to embrace their services and use them more to keep people out of the acute hospitals. Unless we resource our GPs and refuse to accept that our best and our brightest GPs need to be in Canada or Australia to make money, and unless we actually make it a viable business once again, and not just as a supplier of primary health care, then I am afraid the Minister of State’s vision will not happen. We will lose younger GPs and those coming out of medical college will not sign up for the life of a GP unless we resource general practice and bring back the rural practice allowance as a guarantee.

The HSE seems to have washed its hands of this, and the Department moves on a case-to-case basis. Someone whose child is diagnosed with an illness should not have to face the trauma of a delay, even if they are financially secure, but that is the reality. We have all dealt with cases in which there have been delays. The team dealing with medical cards at the primary care reimbursement service are working under huge pressure but they are always helpful. They are an example to other civil servants in their helpfulness and in the provision of information. I thank them for that. However, we should not have to be ringing them. There are still many over-70s falling between the cracks, particularly if they are diagnosed with conditions such as dementia or Alzheimer’s. I am dealing with one horrendous case in which the people in question have the resources to deal with it but they are facing ten years of treatment. They will not have the financial resources in the end unless they get support now. The system does not seem to be able to comprehend that many illnesses will not be cured in the short term but in the long term. People will have to make arrangements around that, but our system is struggling to cope with it.

I certainly agree with the Minister of State’s vision and I have no doubt she is doing her best, but it is not happening. There are still vacancies for consultants because the contract is still not attractive enough to bring our own home, to give them the freedom to do academic research and the private practice they need to engage in. Why do we have so many vacancies on the consultancy front? The legacy of the contract introduced by the former Minister, Deputy James Reilly, is still there and still raw. We have to make this place one to come to.

Today, we saw a massive increase in outpatient waiting lists in general hospitals across the country. Once people get in, they generally get a good service. It is getting harder to get in, however. While we continue to undermine our primary care service, unfortunately, the delays will get harder. Unless we give the National Treatment Purchase Fund the power to get into that space and shake it up, those waiting lists are going to increase.

I apologise for the long sum-up, but the Minister of State gave me some thoughts. This Bill is an improvement, but the health system is under enormous pressure at the moment. Those working in it are fantastic, but we need more working in it, as well as more proper spending and resources.

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