Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

I thank Deputy Kelleher for providing us with the opportunity to discuss this matter this evening. Earlier, the House was discussing the Marriage Equality Bill which was an example of where politics works and of how the House has managed to influence and change society. However, I have lost count of the number of Private Members' motions we have tabled on health during the current Dáil. The one thing I am sure of is that the management of the HSE does not give a damn what this House thinks of it. It will just plough on regardless. One can be damn sure that not one senior manager in the HSE is on a waiting list for any basic service. Senior managers do not have to worry about whether an ambulance will get them to hospital. If they have a cancer fear, they do not have to worry about having to wait for a public service appointment. If they did, they would not stand over the system which obtains or allow the situation which exists throughout the country, and which continues to worsen, to continue.

I received a reply to a parliamentary question on orthodontic waiting lists this evening. Orthodontic treatment is not even a hospital service in most cases. The orthodontic waiting list in the HSE west area for young children in particular stands at over 5,000. Nearly 1,300 have been on the list for between 25 and 48 months. The list is from initial assessment to commencement of treatment. There is a qualification in the PQ reply I received to the effect that in some cases treatment is delayed in order to see how the condition progresses. I cannot imagine the all of the 5,133 people on the list fulfil that criterion. In rheumatology, we discussed the issues around the cancellation of appointments in Merlin Park. Before that, there were 2,500 people in Galway and Mayo waiting for a rheumatology appointment at one of the two clinics in Merlin Park. The outpatients waiting list at Mayo General Hospital has increased by 400 this year. We have moved to a situation where in many rural communities we depend on the goodwill of the HSE to provide a rural practice allowance to recruit GPs. It is not an automatic provision anymore. Communities in Bangor and Glenamoy in my county have had to wait to see if the HSE would provide a rural practice allowance before the ad could be placed. As such, we have been left for months with temporary arrangements in GP services.

There was a discussion today on the ambulance service. I have no confidence in the management of the National Ambulance Service and I am concerned for people in light of the current position in respect of that service. Staff on the ground, including ambulance drivers and paramedics, are doing a wonderful job in incredibly difficult circumstances, as are the staff in all of our hospitals, but they face layers of anonymous people who do not seem to understand the pressure they are under. If those people do understand it, they are not really convinced about dealing with it. That sums up where we are at regarding our health service. We have had a bad summer weather wise. It was a warm summer, which does not augur well for the ability to get rid of basic colds and flus. If we have a busy cold and flu season ahead of us, what will it do to our emergency rooms, which are already packed beyond belief? What will it do to our waiting lists for respiratory conditions which have already spread beyond belief?

The national cancer strategy, into which so much work and political capital was put, is straining because people are finding it difficult to access basic appointments. They are finding that their treatment is being carried out in circumstances and conditions which are unacceptable. The national and regional cancer centre at University College Hospital, Galway, is absolutely straining. The Taoiseach, who is the leader of the Minister's party, opposed that cancer strategy. For four and a half years he has stood by while conditions have got worse. Again, it is not fault of the staff because they are doing their absolute best. The problem is the numbers trying to access the service, many of whom are not getting in as quickly as they should. We must ask ourselves why this is the case, particularly when we are spending so much. Obviously, the Minister for Finance, Deputy Noonan, shares my scepticism about the management of the HSE given the manner in which he slapped down their funding request today. When we are spending so much money, why are we not getting better outcomes? Why is the position getting worse? As long as we have a condition and culture in our public service that people cannot be sacked for bad performance, it will continue to get worse. Those we pay handsomely to manage the HSE will fiddle along while Rome is burning. Rome is burning.

There must be a complete change of culture at management level to start with in the HSE before we even begin to address the problems we are discussing this evening. If we continue as we are - and it seems we will - waiting lists will continue to grow. It is not like national debt or other figures we discuss. Waiting lists involve actual people who have particular conditions and who are awaiting treatment. If one is a rheumatology patient with rheumatoid arthritis or any other condition, one is in pain waiting to see a consultant. One may have seen the consultant but one may be obliged to wait for treatment. One has been brought down the garden path, led to Eden, and then the gates are shut for two or three years. If one is a cancer patient, one does not have that time. That is what the cancer strategy was set up to address. It was to bring emergency expert care to cancer centres. That is not happening.

If one is involved in a road traffic accident, one should not be obliged to wait an hour for an ambulance to arrive from the part of the county furthest from the location in which one's accident occurred, particularly if the scene of the accident is closer to the regional hospital in a neighbouring county than it is to the town from which the ambulance has come. One should not be put through an interview when one calls for an ambulance to find out where one is from and the condition of the patient and then be obliged to wait an hour for the ambulance to arrive. Meanwhile, the patient is on the ground awaiting attention. I was in that position during the summer and we flagged down an ambulance that was on a hospital transfer to give the patient, who thankfully was fine, some privacy and treatment. That took an hour. The two nearest ambulance bases were not utilised and the ambulance in question travelled from one of the bases furthest away. This is the service the manager of the ambulance service tells us is world class.

We need something to be done. We need to start again with primary care. The Minister must invest in primary care and give the power and capacity to primary care services to do the things that do not need to be done in accident and emergency departments or hospitals. Primary care must involve not just GPs but also pharmacists and it must take the pressure off the hospitals. We need an emergency system in which one is seen, triaged and dealt with quickly. The Minister must do something around waiting lists. He cannot stand over a system where in University College Hospital Galway there are 7,300 people waiting, which is an increase of nearly 80% year-on-year in terms of the patient list.

The increase at Mayo General Hospital has been 39%, with more than 1,100 people waiting. Sligo Regional Hospital has seen an increase of 65.7%. These people need treatment and attention. They are sick and, in many cases, are old and have given a lifetime of service, paid their insurance and done everything required of them, but when they look for a little bit of care, our system is incapable of providing it. The worst aspect is that no one in the system's management seems to care. The lists get longer and the people in question keep submitting unreasonable funding requests. They claim that they are throwing money at the problem, but they are actually building their own empires and feathering their nests while tens of thousands wait for basic treatment. That is not a republic.

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