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

-----but nothing has happened. We must accept that our health services are in crisis. There is a deficiency of funding and a lack of capacity. We must increase the number of front-line staff. That will require additional resources and funding.

There are also the other failures in dealing with the problems that manifest themselves in the emergency departments. There are simply not enough community care services in place. The public health nurse system is under significant pressure. There are no community care geriatric services. For example, when people in nursing homes get sick or require medical attention, the nursing homes are often dependent on out-of-hour GP services. It is not good enough in this day and age that out-of-hour GP services are often servicing nursing homes. There must be proper specialist services in geriatrics at community level. What happens, as the Minister sees on his visits to emergency departments, is that elderly frail people are parked on trolleys. They should not be there. They are languishing for an inordinate length of time, which creates greater risks to their health and well-being. The facilities are not available in the community so everything is channelled back into the emergency departments.

The Minister, Deputy Varadkar, and Deputy Twomey, two medical practitioners, are sitting side by side in the Chamber. They should at least acknowledge that our GP services are in crisis. The renegotiation of the GP contract is a critical component in ensuring that chronic illness and disease are dealt with in the GP practices and in the home care and community settings. No efforts have been made to enhance the capacity of our GP services. GPs will tell the Minister in the context of children under six, and he is probably well aware of this, that without enhancing capacity some other group is suffering. GPs are saying openly that their surgeries are overwhelmed with attendances and they cannot give the time required not only to elderly patients, but also to other people with chronic diseases and illnesses. Again, they are being referred back into the acute hospital system.

Many of the policies the Government has pursued in recent years in terms of cutbacks to home care packages, the under-funding of the fair deal nursing home scheme and cuts to home help services - a key decision made by the Government - had a profound impact on people's quality of life and their ability to stay at home with some assistance to help them live as independently as possible. These were policy decisions of the Government. The nastiest one of them all, and one that shows the Government is bankrupt when it comes to basic decency in how it looks after people, was the issue with the discretionary medical card. For over two years the Taoiseach, the Minister for Health and the Minister of State at the Department of Health told us every day that there was no policy change in the area of assessment for discretionary medical cards and the guidelines that underpin it. However, the Minister for Finance, in advance of the local elections in 2014, decided to let the cat out of the bag or the rabbit out of the hat. He said, effectively, that the Government would change the policies but it would wait until after the election as it did not wish it to be seen as an election stunt. There has been dishonesty at the heart of the Government in terms of health care, health funding and the policies underpinning them.

I commend the motion. Sinn Féin has a right to table it. I also have a right to table motions on health and to speak on them on a continual basis. It is not about electioneering, because we have been doing this since the last election, but about holding the Minister and the Government to account. More importantly, it is about ensuring there are clear alternatives in finding pathways to ensure we have health services that provide access to people when they need them and in a timely fashion.

That should be underpinned by proper working conditions for our medical staff who are working under enormous pressure and stress every day in overcrowded, underfunded emergency departments throughout the country. Most of this is the direct result of the Minister's failings and those of his predecessor and the Government's lack of commitment to public health.

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