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

I move:

That Dáil Éireann:

— considers the ongoing crisis in hospital emergency departments a denial of the right of timely access to health care with dignity and a betrayal of the Republic envisioned in 1916;

— remembers inspirational figures such as Dr. Kathleen Lynn, a 1916 veteran and founder of St. Ultan’s Hospital for the Children of the Poor, who pioneered public health initiatives in the most difficult and conservative of times, and recommits to the principle enshrined in the Democratic Programme of the First Dáil Éireann that "it shall be the duty of the Republic to take such measures as will safeguard the health of the people";

— condemns the decision of the Government to not invest adequately in the defence of the nation’s health, which saw an entirely predictable worsening of the trolley crisis in the opening weeks of the centenary year; and

— concurs with the view of Dr. James Gray and other health care professionals who have described as a "national scandal" the Irish Nurses and Midwives Organisation figures that show the numbers on trolleys close to 500; and

calls on the Government to:

— increase the number of hospital beds in the system and reverse the flow of nurses and doctors out of our public health system by committing to ambitious multi-annual recruitment targets and allocating the additional €412 million necessary to increase nursing numbers by 2,500 and consultant numbers by 800 over five years;

— commit to incrementally increasing annual funding for the Fair Deal scheme by an additional €125 million in order to increase nursing home bed numbers by 900 additional beds in year one, 800 additional beds in year two and 700 additional beds in years three, four and five;

— commit to increase home help hours and home care packages in year one by 10% at an estimated cost of €31 million and by a further 10% on the baseline year in years two and three with a resulting rise in spending of €93 million; and

— establish an Emergency Department Taskforce on a permanent basis.

The Taoiseach famously promised ahead of the last election that he would "end the scandal of patients on [hospital] trolleys". He has failed spectacularly to keep that promise.

Not only that, he has now refused to give a commitment to end the crisis if re-elected. This is completely unacceptable. Anyone who is not committed to ending the crisis in our emergency departments is not fit to be elected to the Dáil, never mind the position of Taoiseach. Our health system is in a state of constant crisis. This is not a matter of debate; trolley numbers have spiked, waiting lists stretch into years and medical staff trained at home are leaving in droves due to poor working conditions.

This crisis can be boiled down to two key failings on the part of successive Governments: first, an extreme depth of fundamental inequality in how patients are treated, differentiated on ability to pay and location; and second, the sheer incapacity of the system to deal with even demographic pressures, evidenced particularly in our emergency departments and maternity care.

Universal health care, not universal health insurance, is the solution. Sinn Féin is committed to the realisation of a world-class system of universal health care that is accessed on the basis of need, free at the point of delivery and funded by progressive taxation. We believe there is no greater good worth striving for. Whether it is a headline about elderly patients on trolleys in emergency departments or children waiting more than a year for speech and language therapy, the common thread across all these stories is the lack of capacity in the system to meet demand. A lack of capacity means that those in our society who need urgent medical care and attention are left to suffer needlessly as governments dither and introduce tax breaks for the better off in society. An unnecessary tax break is of no use to anybody lying on a trolley in a draughty corridor, racked with pain and worry. When we talk about capacity, we talk about vulnerable people.

Many young Irish people want to become doctors, nurses, surgeons or dentists. They go to college and study for years in a system that grows more expensive by the year. When they graduate, they are faced with a health system ravaged by years of austerity, recruitment embargoes and funding cuts imposed by the Fine Gael and Labour Party Government and by Fianna Fáil before them. For too many, the choice is plain and emigration is the result. If we are to stem the flow of doctors, nurses and others from our health system and attract those who have already left to come home, then we must commence sustained action to address the single biggest factor influencing medical migration – the toxic work environment that currently prevails. Ad hoc, half-hearted recruitment drives will not cut it. To foster and maintain a productive and motivated medical workforce, we must put credible light at the end of the tunnel for staff showing that things will get better and will stay better. We must guarantee to this workforce that the intolerable staff-to-patient ratios will be improved and sufficient resources will be forthcoming which will allow them to practise medicine and provide health care, not firefight and pen-push. This requires a commitment to ambitious multi-annual recruitment targets with revenue allocated to back these up.

In a term of government, Sinn Féin proposes to recruit more than 6,600 consultants, doctors, nurses, midwives, dentists, vital administrators and allied health professionals to reinforce the front lines of our health system. Overcrowding in our emergency departments, and more generally across the health service, has long been at crisis point. The trolley watch figures provided by the Irish Nurses and Midwives Organisation, INMO, regularly highlight the impact of decades of Government failure to provide adequately for the sick and the vulnerable. The INMO trolley watch and ward watch figures for December 2015 show that the level of overcrowding has decreased by 13% compared to December 2014. However, a year-on-year analysis shows that there was an increase of 21% in overcrowding from January to December 2015 compared to the same period for 2014. Yesterday 356 patients languished on trolleys.

The crisis is partly a reflection of inefficiencies within the system. Not all hospitals discharge seven days a week, for example, but in the main it is directly due to lack of capacity in terms of staffing and bed numbers. There is also the shortage of exit packages, including in the provision of home help hours and home care packages and inadequate numbers of long-stay nursing home beds. Research on overcrowding in emergency departments consistently shows a direct negative correlation between emergency department waiting and length of inpatient stay and, very importantly, with overall outcome. Overcrowding is not just a bad use of resources, it has a direct impact on patient safety and mortality.

Sinn Féin is putting forward this motion in an effort to address seriously the situation in our emergency departments. We need to increase the number of hospital beds available in the system in order to move people from trolleys and into wards. We need to recruit more nurses into our emergency department and acute hospital system. We also need to increase home help hours and home care packages to help support older people in their homes and take pressure off our hospitals. Alongside these measures we need to increase funding for the fair deal scheme further to secure more nursing home beds immediately and we need to develop the capacity of our public nursing home provision. All of this requires serious investment and that is what Sinn Féin is committed to. We are committed to quality public services that benefit everyone.

This motion refers specifically to inspirational figures such as Dr. Kathleen Lynn, a 1916 veteran and founder of St. Ultan's Hospital for the Children of the Poor, who pioneered public health initiatives in the most difficult and conservative of times, and it recommits us all, I hope, to the principle enshrined in the Democratic Programme of the First Dáil Éireann that "it shall be the duty of the Republic to take such measures as will safeguard the health of the people". The ongoing crisis in hospital emergency departments denies our citizens their right to timely access to health care with dignity and is a betrayal of the Republic envisioned in 1916.

This can be changed. Contained in this motion are realistic proposals that can do exactly that. We specifically call on this Government and the next Government to increase the number of hospital beds in the system and reverse the flow of nurses and doctors out of our public health system by committing to ambitious multi-annual recruitment targets and to allocate the additional €412 million necessary to increase nursing numbers by 2,500 and consultants by 800 over the five-year Dáil term.

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