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

The Minister did his best to talk down the crisis in our health services but he will now have to hear some of the reality of the impact on service users and those dependent on it. Reports last week of a 91-year-old man spending 29 hours on a trolley in Dublin’s Tallaght hospital, while his wife was also on a trolley for nine hours, depict a health service that is on its knees. This news emerged following a letter from Dr. James Gray, an accident and emergency department consultant, to the chief executive of Tallaght hospital, in which he claimed that there were "grave and dangerous governance failures". The position in which this elderly man found himself was absolutely appalling and a clear violation of his basic human rights. Last week, there were also horrific newspaper reports of an elderly woman placed in an all-male ward due to overcrowding in South Tipperary General Hospital and who was allegedly subjected to a horrific sexual assault. Another report is that of Mr. Dualtagh Donnelly, the father of two who bled to death while waiting 40 minutes for an ambulance to arrive, despite his family home being only five minutes from the Dundalk ambulance station. He lived close to Louth County Hospital, where the accident and emergency department has been closed. This litany of horrendous events stretches way back. In December 2014, an 87-year-old woman spent 57 hours on a trolley and a chair in a hall in University Hospital Limerick. In June 2015, two elderly ladies, both over 100 years old, had to suffer the indignity of spending more than 24 hours on trolleys while awaiting hospital beds. In September 2015, an elderly cancer patient spent five days on a trolley at Our Lady of Lourdes Hospital in Drogheda.

These are not isolated incidents and I am sure there are many more of which we have not heard. Our health service is a shambles. Overcrowding continues to increase and all measures taken to date have failed to address the critical issues of bed capacity and staffing. Last month was the worst October on record, with 7,971 admitted patients cared for on trolleys. In the first ten months of this year almost 80,000 admitted patients were on trolleys, which is the highest ever figure for the first ten months of any year since trolley watch began. According to the Irish Nurses and Midwives Organisation, INMO, in October, for the 15th month in a row, there was an increase in the level of overcrowding in accident and emergency departments. The latest monthly figures also confirm that 25 of the 29 accident and emergency departments have endured an increase in overcrowding in 2015 compared with the same ten-month period in 2014.

Beaumont Hospital's accident and emergency department recently had to go off call as a result of severe overcrowding. It is unbelievable that in 2015 patients and workers alike have to deal with conditions like this. As a result of these intolerable workloads, the INMO has begun balloting its members working in accident and emergency departments in respect of possible industrial action. This Government, faced with the enormity of the challenge of dealing with this crisis, has utterly failed in its obligation to alleviate the suffering caused by a health system in tatters. Efforts by the Government to date have amounted to little more than a stand-still response, holding things as they have been rather than investing and resourcing the identified needs of our health service.

The latest fanciful notion from this Government and the Minister's mouth is that hospitals that consistently underperform will see their management passed over to a private operator. I am aghast to think of how this would affect patients, particularly as they would then be at the mercy of a profit margin. The Minister also wished to incentivise hospitals to do more work. This would suggest that the overstretched men and women in our hospitals - in whatever role they play - could be induced to do more for our health service. This is simply not true, as the nurses in St. Vincent's Hospital have been forced to take industrial action to highlight.

Last week, the Minister, Deputy Varadkar, stated that it was "indefensible" that any patient was forced to spend more than 24 hours in an accident and emergency department. I remind him that he also stated a number of months ago that there would be "zero tolerance" of patients requiring hospital admission waiting in accident and emergency departments for more than 24 hours. So much for zero tolerance. He continually states that there is a plan in place but this plan is not working. The crisis is escalating at a ferocious rate.

A severe shortage of nurses is a major contributory factor in the current crisis. Nurses are choosing to go abroad because of poor working conditions and the lack of career prospects here. A Health Service Executive recruitment scheme to encourage Irish nurses working abroad to return home and take positions in the health service here has been extended after it managed to attract just 77 people. The aim behind the nursing in Ireland initiative, announced on 23 July, was to recruit 500 Irish nurses and midwives within three months. At least 4,000 additional nurses are required as a matter of urgency in our health service. The Government must engage in a massive recruitment campaign to bring nurses back home and encourage more nurses training in Ireland to stay in service in their own country. This must be combined with a drastic improvement in working conditions at home or else all will be for naught.

This is not about money, although the Government has made matters worse through its savage cuts under the financial emergency measures in the public interest legislation in recent years. Our public health service is severely under-resourced and requires a commitment not only to new investment but also to the public ownership model itself. This seems not to be forthcoming from Fine Gael and, even more disgracefully, from the so-called Labour Party. The Government has provided €18 million euro in additional funding for health in 2016 when demographic pressures and the Lansdowne Road agreement are stripped out. That is what the budget 2016 document says and that is what the Minister, Deputy Howlin, placed on the record in this House not many weeks ago, and yet the Minister still provides multiples of that with his colleagues in Government - nearly ten times that amount - in tax relief to those who earn in excess of €70,000. This is a damning indictment of the Government's approach to the health crisis.

See this speech in context