Dáil debates

Wednesday, 23 September 2015

Hospital Waiting Lists: Motion (Resumed) [Private Members]

 

7:55 pm

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I thank all Deputies who contributed to this debate. Having listened with interest to the contributions from all sides of the House, it is clear there are challenges in our health services, which in itself is an understatement.

I am amazed and perplexed by some of the contributions of Deputies on the Government side, in which I was accused of playing politics with the health services. I have been Fianna Fáil spokesperson on health since the previous general election. I can safely say that my criticisms are justifiable and are based on observations. We try to come up with solutions to the challenges in our health services.

The Government sought a mandate to abolish waiting lists and lengthy waiting periods on hospital trolleys, to introduce universal health insurance, increase capacity in our hospitals and introduce reforms that would enhance the ability of the health service to deliver care. The great universal health insurance plan, abolition of the HSE and recruitment of additional consultants were key commitments made to the people in 2011. The Government sought a mandate on those proposals but has since then consistently denied that to be the reality.

I am not the one who stood up on the lorries in Roscommon, Cavan, Drogheda, Galway, Cork and Monaghan or who sent letters to constituents promising that all hospital services in their areas would be retained. I have not played politics with the health issue because it is much too important. The difficulty for the Government is that it sought a mandate to improve the health services and made solemn promises which have not been delivered on. We have a crisis in our health system. This must be acknowledged and addressed. Choices will have to be made. At the commencement of this debate last night I said that the Government will have to make choices in the next number of weeks on what is to be prioritised. Will it prioritise the 80 year old woman who is waiting 18 months for an outpatient appointment? Will it prioritise the child who cannot access speech and language therapy? Will it prioritise the elderly man who receives only half an hour a week of home help or will it prioritise those who do not need those services and can live within the resources they have? They are the choices the Government will have to make in a couple of weeks time when it presents its budget to this House.

Let us move away from the pretence that it is for historic reasons that the Government cannot address some of these issues. All these promises were made in the full knowledge that the country was facing difficult financial circumstances. None of these promises was made in the golden era, rather they were made in the darkest hours of the country. Members of the Government stood outside hospitals and said on television programmes that even with the financial challenges it faced on taking government, it would resolve all these issues. The point is that it has not done so. We still have huge numbers of people waiting day in, day out on trolleys in emergency departments. We have an escalating crisis in the outpatients appointment system. The inpatient system is crumbling. The answer from Government to this is to change the targets from one year to 18 months. The Minister of State, Deputy Deenihan, alluded to this in his speech when he applauded Government on the €51 million in funding provided to the HSE directed towards reducing lengthy waiting times by optimising internal capacity and using targeted initiatives where necessary, which ensured that by June waiting times had fallen below maximum permissible waiting times of 18 months set by the Minister. The previous waiting time target for outpatients was one year and for inpatients was nine months. The Government has shifted the targets because the figures were so alarmingly bad. These are not gross national product or other figures often spoken about in this House, rather these are real people, many of whom are in agony and pain and unable to access a consultant in a timely fashion to find out what is wrong with them in order that they can be treated in a timely manner.

There has been a massaging of the figures. Deputy McConalogue referred to patients being put into the private system, assessed and returned to the public system, following which, when the figures increase again, these people are referred to the private system again. That is not good enough. I am not the one who had no confidence in the ability of, in particular, the previous Minister for Health, Deputy Reilly, to deliver health care. I am not the one who moved him to the Department of Children and Youth Affairs. The Taoiseach had no confidence in the previous Minister to deliver on the commitments. It was because there was no delivery on the commitments made that the previous Minister for Health and Deputy Leader of Fine Gael, Deputy Reilly, was sidelined and moved to the Department of Children and Youth Affairs. The Taoiseach said he would take a hands-on approach in terms of assessing what the Department of Health and Health Service Executive required in budgets.

As late as today the Minister for Finance, Deputy Noonan, said that health system budget control is not up to scratch, following which he berated Mr. O'Brien, director general of the HSE, for seeking €1.9 billion. In June of this year the Minister for Health, Deputy Varadkar, stated that it is estimated that satisfying the unmet needs will cost between €700 million and €1 billion, on top of the natural increase needed yearly to cope with the rising ageing population. When the Minister, Deputy Varadkar, highlights how much is required to fund a proper health system, it is okay, but when poor Mr. O'Brien does so, he is berated for inefficiencies and incompetence. The Government cannot have it both ways. One day the Minister, Deputy Varadkar, arrived into the Dáil and told me that all the problems in the health service are not all resource-based. In an article in the newspaper the following week he stated that he needs at least €1 billion. The reality is there are resource problems in the health service. There is not enough capacity. Our emergency departments are overcrowded and we are unable to shift people from the acute hospital setting to step-down facilities or their homes or other community facilities. There are blockages across the system.

There will be 600 people in the acute hospital system tonight who should not be there and do not want to be there but there is no place for them to go. They are healthy, in effect, but cannot leave hospital because there are no facilities to which they can go in terms of home care packages, home help supports, community step-down facilities or long-term care.

9 o’clock

That is happening tonight. Moreover, it will happen tomorrow night and the night after. Surely, it is not beyond the ability of this Government to address the issue.

Reference has been made to opening up 300 beds. Those 300 beds will come on-stream at the end of this year, but we have already taken thousands of beds out of the public hospital system throughout the country. It is true that some of that happened on my watch, but I was not one of those promising to increase the number of hospital beds at the last general election. I was telling the people the reality. I did not stand outside hospitals and promise to build a new hospital in the north east, maintain services in Roscommon or maintain services in Mallow. I was not one of the people who made those pledges. However, I am certainly going to ensure that I hold those in the Government to account for the pledges they were elected on. I would be failing in my duty if I did not. That is why I will consistently and continually put down motions in the House.

Such motions are not calling for a major or inordinate increase in the level of funding required. Today, I was accused of spending billions under this motion, but I have simply pointed to some key areas with regard to the National Treatment Purchase Fund and the recruitment of additional consultants. This is simply about enhancing the capacity of the emergency departments and the throughput in hospitals. These problems are primarily self-inflicted by the Government by undermining the fair deal scheme and community nursing home facilities for a long period as well as undermining the home care system through the reduction in home help hours and the inability to move people from an acute hospital setting to a more formalised setting more suitable for their needs. Such measures could enhance the ability of the emergency departments to address some of the problems with overcrowding.

I commend the motion and I make no apology for it. I would be denying my responsibility as an Opposition spokesperson by not holding this Government to account. Primarily, I will hold those in the Government to account on the commitments on which they sought a mandate, although they are denying that they said these things every day of the week. It is shameful that they are doing so on a consistent basis. At the least they should stand up and declare what they committed to, as against what they are actually doing, and be honest about it. The idea that they are denying their mandate is beyond belief at this stage. The people deserve better. More important, the thousands of people waiting on hospital lists throughout the country deserve better. The hundreds waiting on trolleys tonight, tomorrow night and the night after certainly deserve better. I commend the motion and I thank Deputies for supporting it.

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