Peadar Tóibín (Meath West, Sinn Fein) | Oireachtas source

11 o’clock

One of the major legacies of this Government with regard to health care is that access to health care is reducing. Little by little, access is becoming more difficult in every route to health care. This can be seen at GP and ambulance levels, in overcrowded emergency departments and with regard to waiting lists. This State had 601 people on trolleys in a single day. In my region, Navan and Drogheda hospitals had 9,000 people on trolleys last year. That is equivalent to the population of the town of Trim being on trolleys in the period of a single year. It is a shocking scenario. This leads to delayed diagnosis, delayed treatment and sub-optimum health results. The practical facts for people are that their illnesses or injuries become worse and in some cases their lives will be shortened as a result.

The waiting lists contain shocking figures. There are 68,000 people on inpatient waiting lists and 385,507 people are waiting for outpatient appointments. A total of 20% of the State's population has no medical cover whatsoever. Budgets for disability services have been reduced by €159 million. One in three ambulance calls in the State that are classified as emergencies are responded to late. For example, in a one year period in my constituency I was contacted by 40 people who told me that the response to their ambulance calls had been longer than one hour. In seven of those cases, a fatality was involved. I am not saying that the fatality is a direct result of the late ambulance but, undoubtedly, in many cases the health result is far worse when the ambulance is very late. There are children on painkillers waiting for more than six months for dental treatment, while 3,000 children are waiting for mental health services. There is also the backdrop of suicide rates in that regard.

I will discuss one case which I previously brought to the Minister's attention in a parliamentary question. It involves a number of different aspects of the health service, including accident and emergency. One of my constituents in County Meath lives four minutes away from the hospital. Her son called an ambulance for her after she suffered a stroke. The ambulance arrived 40 minutes late. She went into Navan hospital where she received decent treatment. However, she was clinically discharged for 13 weeks, unable to proceed to the National Rehabilitation Hospital due to the fact that it was under fierce pressure. When she went to that hospital, she received treatment and reached a certain level of rehabilitation whereby she was able to return home to live with care from her family. Unfortunately, about a year later she had another stroke. She went back into the hospital and very quickly had a good recovery. However, she was brought to the shower one day with the assistance of two nurses. One of the nurses was called away due to how busy the hospital was and the woman fell and suffered a head injury. As a result of that injury, she was brought to a Dublin hospital. That hospital gave her the wrong blood. She has been in a coma for three or four months and has had internal organ failure as a result. She is coming back very slowly. Thankfully, her mind is showing a strong level of clarity but she is in a bad way physically. She is 68 years of age but she probably will be unable to return home and is likely to remain in a nursing home.

Consider how much it would have cost to have an ambulance arrive on time on the first occasion. How much would it have cost to enable the two nurses to remain with the patient? How much would it have cost to have the necessary resources in the hospital to provide her with the proper bloods? Measure that against the cost of her nursing home care for perhaps 20 years or more. That is the key issue here. The Government is on a fool's errand. It is slashing back on access to hospitals and people's illnesses are becoming more acute, so the treatments that are necessary for them are becoming more expensive. The Government thinks it is saving a few quid at the start, but in the long run it is being forced to put an increasing amount of money into the health services.

Another aspect of access to health care in County Meath is North-East Doctor on Call, NEDOC. Before Christmas, it was brought to my attention that there was no doctor available for North-East Doctor on Call. People had to travel all around the country at night if they required a doctor, or they had to go to the accident and emergency department. Since Christmas, we have been told that a family with young children called to NEDOC in their locality and had to wait four hours for treatment. There were dozens of people waiting in a room which was not built to accommodate those numbers. NEDOC cover had to go from Drogheda to Athboy because there was no cover in Meath. That means all of County Louth is unavailable for doctor on call. What is the Government's response to this and investing in NEDOC? I understand its response is to run a pilot scheme whereby there will be a remote doctor in a location in Dublin speaking through Skype to a patient, possibly with a paramedic present. Will that paramedic be able to deliver prescribed drugs to the patient in that scenario? Is a diagnosis that is made 40 miles away from a patient of the same quality as one where the doctor is sitting in the room with the patient? Cutbacks in NEDOC are causing more trouble for patients and more trouble for the system.

Navan hospital was part of the north-east group. When the hospital in Monaghan closed, the trolley counts in Cavan spiked. When the accident and emergency department in Dundalk closed, the trolley counts in Drogheda spiked. It is now part of the Government's plan to close the accident and emergency department in Navan. The Minister visited the hospital and said it would be a long time before it will be closed, but current Government policy is articulated through the small hospital framework document and that states that Navan hospital will be reduced from a level three to a level two hospital. Navan will lose services with regard to coronary care, the intensive care unit and anaesthesia. That means the hospital will be unable to take the same amount of people.

I have also received information that the national clinical leads in the HSE responsible for policy in hospitals met with Ireland east managers in early December and agreed a series of changes to the delivery of hospital services in Navan which will convert that hospital to a level two hospital. The hospital staff were not told; I was the first to tell them about these decisions. They have not been told when these decisions will be implemented. The GPs in the area also have not been told when the decisions will be implemented. It should be noted that 130 GPs in the Meath area have stated that the health outcomes of citizens in County Meath will be radically reduced if the Government proceeds to reduce the accident and emergency services to shorter hours or to close those services. This is completely inconsistent with what the Minister said when he visited County Meath, as is the HSE small hospital framework document.

What we are seeing develop in the State is a reduction of access to hospitals, especially public hospitals, for people who do not have private health insurance. However, some of the private hospitals, particularly in the Dublin region, have opened emergency department services and they do not have the same level of trolley occupancy, waiting and so forth. The cleavage between those who can afford private hospitals and those who cannot is becoming even clearer. The backdrop for this is the Government gouging funds and staff from the health service over the past number of years. It shocks me that when I put questions to the Minister for Finance about his plans for the next five years, he replies that the major plan for those years is to reduce the universal social charge, USC, by €3.5 billion to €4 billion. At the same time we have this ongoing crisis. The Minister cannot have European public service delivery and European infrastructure based on American taxation. He is either rewriting the economic laws of the planet or he is lying to the people. It is very serious to allow this level of inaccessibility to the health service and this level of a health crisis for the people yet at the same time totally focus tax breaks on those on higher incomes.

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