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

No, but I will take possession if the Leas-Cheann Comhairle so wishes. When the Minister came to the House it was quite obvious he bypassed the Department of Health and went straight to the Fine Gael press office. He more or less read a Fine Gael press release into the record of the House. Time and time again health services and emergency department overcrowding have been debated in this House. There has been, unfortunately, very little response from the Government to the ongoing crisis in the Department of Health, in the health services and with the delivery of care. It is happening day in and day out but the Minister comes in and effectively dismisses the legitimate claims of Deputies opposite that health services are under-resourced, with undercapacity, increasing delays in access to outpatient and inpatient services and overcrowding in emergency departments. Many Deputies on all sides of the House say that consistently in this House. The motion has validity in the sense that it raises the genuine concerns and experiences of individuals over a long period of time who have been languishing on trolleys for inordinate periods.

Emergency medicine consultants say on a daily basis that health and the lives of patients are being compromised. An actuarial or statistical analysis would tell us that people are dying because of overcrowding in emergency services and there is a detrimental impact on health outcomes for people who languish for inordinate periods on trolleys.

I found one paragraph in the Fine Gael press release quite fascinating, which the Minister actually failed to read. I do not know if it is in his script but it is in the one presented to me. After some historical lecturing, we have, "In contrast the Government has developed plans recognising the range of difficulties confronting our health services and the reality that it will take a number of years, resources, commitment and long-term thinking to achieve fundamental improvement." That is the kernel of the issue because the Government does not have a plan. The bottom line is that the Minister of Health would not be the Minister if the policies being pursued by this Government were successful. The last Minister for Health was sacked and it was not the Opposition who sacked him but the Taoiseach of this country, because of the ineptitude, the inability to manage the health services and its budget and the inability to put in place proper measures to ensure that the basics of the commitments made by the Government would at least be honoured.

The Minister was also brought in to euthanase universal health insurance with a smile, to let a key, central plank of Government policy fade into the ether. We are not being alarmist in highlighting the lack of any strategy or coherent plan from the Government. By its own admission, the previous Minister, Deputy James Reilly, the deputy leader of Fine Gael, was sacked. It was very evident early on that the model being proposed for universal health insurance, the Dutch single-tier universal access model which was fed into the programme for Government, was going nowhere but the previous Minister could not admit the failure so it was handed to the current Minister to let it fade away gently into a distant memory. Unfortunately, the difficulty is that there is now no plan from the Government. The Minister talks about long-term thinking to achieve fundamental improvements and acknowledges all the things the Government is doing to address the problems, but all those things are addressing the problems it previously created. When he took office in 2014, one of the first briefings the Minister received was on the lack of stepdown and home care packages and the cut in home help hours feeding into the difficulties with delayed discharges and the inability to get people through the hospital system and through the other side with stepdown, community care and nursing home support schemes. It effectively took the scandal of people having to wait for 20 weeks to be approved for fair deal before the Minister acknowledged that this was a problem.

The Government consistently only acknowledges problems when there are crises in certain areas. This month, January, is no different from any other month in recent years in terms of overcrowding in emergency departments. There has been a litany of horrific individual cases with regard to the amount of time people have had to spend on trolleys in emergency departments throughout the country. The Taoiseach has previously expressed shame and anger in the Dáil about what was happening, only to find that it happened again the following day and the day after. This is particularly the case with elderly people. Over Christmas, I was asked by a family to make a telephone call to the HSE and to a hospital. Their 91 year old father who had pneumonia was on a hospital trolley and was facing a second night parked in a corridor in the emergency department. The man was subsequently put into the hospital system, was successfully treated and was later discharged. However, for the first 40 hours he was on a trolley, with the nurses and doctors trying to deliver the best care they could under those circumstances.

The Minister has conducted whistlestop tours of emergency departments; he claims he has done them two or three times. If he continues to do them so frequently, he will meet some of the same patients again. They will still be in the emergency departments as they will be waiting so long. The difficulty is that nothing is happening to address the underlying problems. The Minister has read the policy documents of the Opposition parties, and we thank him for that. We would also appreciate if there was a little more engagement in general and intense debate over the next number of weeks about what we expect from our health services, what we demand of them and how we intend to fund them.

The Minister cannot say he is committed to addressing all of the underlying problems in health while the Taoiseach is travelling around the country saying that the taxation base will be cut to the point where it will be unable to sustain public services in general. There will be a plethora of promises. The Taoiseach is effectively like an auctioneer at this stage. Wherever he sees something he will throw out the best bid possible. In the past number of weeks there have been consistent briefings on the increased intent to buy the electorate through tax cuts. At the same time, the Government will be promising increased numbers of consultants, nurses, teachers, gardaí and better public services. If the Government fulfils that, it will require a taxation base, but it is effectively eroding that base. Commitments to public service require that there is at least an honest debate about how it is intended to fund them. The Government's policy in its tax cut proposals is an American style taxation model where, effectively, it is a case of winner takes all. The more one earns, the less one pays.

We must be honest with ourselves. If we wish to sustain public services, there must be some concept of a commitment to a progressive taxation model that funds them. In all of the Government's budgets since it took office, the Labour Party was there to pretend its purpose was to keep an eye on the Fine Gael Tory policies, but that did not happen. There have been five regressive budgets in which those who are suffering most and in financial hardship are expected to pay proportionately more. Property tax and water charges are arbitrary. There is no ability to pay clause. Pensioners have had the €2.50 prescription charge foisted on them despite another key commitment made by the Government. The problem is that all of the Government's policies were based on focus groups. There was not a person in this country prior to the last election who was not sitting around a table somewhere being paid a few euro to say what commitment they thought a political party should make. The country was focus grouped out of it. The parties in Government had all of that data and information, and then published policies to appease the various sectors of the electorate. The difficulty is that they were not able to follow through on those promises. The universal health insurance model is a key component of that.

One can drill down from the national policies to the policies in local areas. The Government parties promised the maintenance of hospitals, to enhance the services in hospitals and to build new hospitals. A new hospital was to be built in the north east, for example.

See this speech in context