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

Four and a half years after taking office and probably weeks from a general election, this Fine Gael-led Government, with the so-called Labour Party in tow, has demonstrated, as no Government before it, that no matter how one dresses it up or who one puts forward to front the health service, without a coherent health policy, the result will be a shambles, and so it is across key areas of the health system today. While so many work so hard, as must be acknowledged with great sincerity, and give of their very best and even more, we have a health system that is unable to cope or meet the needs of the population and is abandoning targets week after week.

The word "crisis" has become synonymous with the health service in the minds of hundreds of thousands of citizens. These are, in the main, people who are dependent on the public health system, most of whom cannot afford to buy fast-track access to consultations and necessary procedures. Many have had to suspend their working lives for months on end awaiting access to services and these waiting lists are set to continue and grow. Each and every one of us knows some of the people of whom I speak from our constituencies and communities. They are real people. From my observations, the designation of non-emergency or elective cases for certain conditions fails to take into account properly the debilitating reality for suffering patients - and suffer they do, as do their families, especially dependants, in many cases for long periods.

The figures for trolley use coming from many of the largest hospitals over the so-called summer months, now past, must ring alarm bells at hospital management and HSE governance level as well as within the Department. If, however, these bells are ringing, it is clear that no one is listening. Extra beds are not enough and the 300 recently announced beds would not even begin to address the problem, even if the necessary additional staffing were in situ, which they are not. The nurse recruitment campaign entitled "Bring them Home" is a dismal failure. We have lost a generation of Irish-trained nurses to hungry recruiters overseas and they are not coming back with the lifting of the embargo. Much more needs to be done to entice anywhere close to the required numbers to resettle here. While salaries are not everything, they remain a key consideration alongside working conditions, the hours to be worked and the career advancement pathways that many in nursing now seek.

We have a critical shortage of consultants across many specialties and we are unable to hold on to many locally trained doctors, resorting instead to recruiting in other countries. I regret to note that we do not always ensure the required communications skills of those so recruited meet our population's needs. That is often an issue presented to Deputies and other elected representatives at locations nationwide.

As with Irish-trained nurses, Irish-trained doctors measure the attractiveness of any employment prospect not only by the level of remuneration but also by working conditions, adherence to the European working time directive and the prospect of achieving career development and advancement, including to consultant roles across the network of hospital sites. We have a serious under-provision of consultant posts, notwithstanding the Minister's comments on this issue. Moreover, a significant number of approved posts remain unfilled. As the Minister and I both know, nurses, doctors and beds are the A, B and C stuff, yet four and a half years after taking office, the Government has failed to appreciably address these needs.

The serious lack of supports for older citizens, especially those who are challenged by dementia, including the serious under-provision of long-stay public nursing home beds, shows contempt for senior years members of our families and communities and is doubly contemptuous given that many of them, having been hospitalised, are retained in acute hospital beds for months and insultingly referred to as bed blockers by some political voices and commentators. We would all do well to remember that many of these older people have given a lifetime of work and service and contributed of their best to society and the economy.

Were it not for the initiative - I note the remarks made by the Acting Chairman, Deputy Durkan, when he addressed this issue - of the private sector in developing private nursing home opportunities, where would many of our loved ones be who are beyond living either alone or largely alone in safety and with their dignity intact?

As a State, we are abrogating our responsibilities to our older citizens and we are depending more and more on the private sector to bail us out of those responsibilities. Delayed discharges are a consequence of Government failure, and a failure of successive Governments. This, in turn, contributes to fewer beds being available for those who really need them. I have checked the statistics for the hospital group that covers my constituency area and there were 175 such beds across the RCSI group of hospitals as of 8 September 2015. I understand this is not the worst example across all the groups as of that date or indeed generally. That was 175 beds across the RCSI group of hospitals on that date that could have been taken up by people in our emergency departments awaiting access to hospital beds or those on trolleys or in other inappropriate placements. Emergency department overcrowding and, again, the inappropriate placement of patients on trolleys and in chairs along our hospital corridors are consequences of this failure. What is ahead of us with the winter months looming? We can only be facing into yet another winter of discontent with more and more patients on waiting lists, on trolleys and in distress. The greatest number of these will come from the more financially challenged sections of our society. With ever widening health inequalities in evidence, the time ahead will be difficult for those in need of care and those who are expected to provide that care. We need to listen to the alarm bells.

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