Liam Twomey (Wexford, Fine Gael) | Oireachtas source

We should view the health service in the same way that doctors view it, in other words, through the lens of acute and chronic issues. The former include the issues Deputies have raised today, such as the way in which emergency departments operate and the need to have people seen and treated quickly in emergency departments. Deputies like to use the figures provided by trolley watch because they are comparative, simple and may be used to have a go at the Government. There are 344 people on trolleys today, which is less than were on trolleys on this day five years ago. People waiting on trolleys will be an annual problem for the foreseeable future because it is caused by the way in which the health service is organised, as the Deputies opposite are well aware.

It is great that funding for the health service increased this year, following a series of cuts in budgets in recent years. It is not beyond the comprehension of Opposition Deputies that these cuts were necessary given the economic crisis the country experienced, including the significant decline in Government income during the recession. As someone who has been intimately involved in the health service for more than 30 years, I can attest that the cutbacks of the past five years could have been much worse. Health service staff acted commendably in exercising their responsibilities and ensuring that access to services for the acutely ill was maintained throughout the crisis. It does not suit the Deputies opposite to hear this sort of thing but staff in acute hospital services, including accident and emergency services, and primary care rose to the challenge.

Reading through Sinn Féin's health policy document, I note that the party fails to understand what problems the health service will experience in the years ahead. These include obesity, diabetes, high blood pressure, high cholesterol and low levels of activity among large sections of society. The first five pages of Sinn Féin's policy document feature only three lines on the future crises in the health service. If we do not tackle the issues to which I referred, the health service will need more than an additional €1 billion per annum just to stand still. The population is not only getting older but is also less healthy than it should be because of the problems I have identified.

I have been a doctor for 20 years. When I started in medicine, I did not expect to diagnose men in their 40s with diabetes, nor did I ever consider that I would have to check the fasting glucose of a 40 year old. I would have expected to make such a diagnosis or carry out such a check on people in their 60s or older. Nowadays, people in their 40s are being diagnosed with diabetes, with all the complications the condition entails.

These include blindness, heart disease and amputations because of peripheral vascular disease. These problems correspond to vast costs and a major burden on health services now and in future. We may believe that hundreds of people on trolleys throughout the country is a national crisis, but I envisage an obesity crisis and all the problems that it brings. The numbers run into the hundreds in my small corner of County Wexford. If we expand that to the rest of the country, it runs to hundreds of thousands and a crisis, an epidemic, waiting to explode in our health services. By the time I retire, that figure will be in the millions. We are not having the appropriate discussions in this House on that problem. We are going for the short-term political hit instead. Opposition Members have taken the view that they will try to hammer the Government on 300 or 400 people on trolleys overnight when there is a crisis coming down the road towards us.

I was listening to the Fianna Fáil health spokesperson earlier. He was completely oblivious to the fact there might be any problems in the health service in the coming decade. That is not surprising because in the 15 years those in Fianna Fáil were in power they made no policy changes whatsoever to allow for this crisis coming down the road.

We should give the Minister, Deputy Varadkar, credit. He is not only changing policy in the Department of Health, he is doing something more. He is funding the change to policies to allow this to happen. We are funding diabetic care management programmes and asthma programmes in primary care. We are genuinely making an attempt to deal with this for what it is, that is to say, a crisis that is about to explode. There is a need for everyone in the House to recognise this, especially those in Sinn Féin, if they see themselves as a serious all-Ireland party. However, one must read up to page 42 of the Sinn Féin health policy document before there is any mention of what this crisis is going to be like, where obesity is going and what that party is going to do about it. It is unbelievable how much this epidemic is going to cost in our health services. Moreover, it is going to happen within the next 15 years if we do not plan for it now. That should be something that we all talk about in the House. It is something we should take more seriously, rather than the cheap political point scoring that has very much been a part of this debate. I would prefer a more consensus-based approach to the future health care of the people.

I am leaving politics as soon as the next election is called. I will have been 14 years in this House and 30 years as a doctor. Unfortunately, I have seen the quality of the debate about where our future health service is going and it has not changed much in this Chamber. It needs to change radically.

We are lucky. The Minister, Deputy Varadkar, is getting the policy changes and the approach we need to address the problems in a way that is going to make a major change to the lives of the people. None of the Deputies opposite have to deal with - at least I hope they do not, either personally or with their families - the complications and consequences of the unhealthy lifestyles that so many of our population are living with at the moment. It is absolutely debilitating for the individuals and their families. It is coming on at such a young age. There are people in their 50s who cannot walk the length of themselves because of the complications of blood pressure, diabetes, obesity and all the other chronic illnesses that we are simply not taking seriously. We are condemning people to be almost imprisoned in their own bodies because of the complications associated with these diseases. The only solution really is to have a broader approach. We need to see that as the national crisis. This is the crisis we should be taking seriously in this House.

I remember having these debates in this House ten years ago when I was a health spokesperson. We saw it as something that was coming, but it is here now and it is getting worse. That is where the approach to these debates should focus. I hope that when the election is over and the heat is gone out of these debates, we can come to the House and give full support to the Minister, Deputy Varadkar, and the people in the Department of Health to allow them to implement the policies and get the resources to make the necessary changes.

Not all the issues that are problematic in health relate to resources. There are still incredibly restrictive practices within the health services and in the way the health services operate. They cost money and waste resources and are detrimental to people's health care. I offer one example. A good friend of mine was admitted to a major hospital in this country two weeks before Christmas. She was admitted for an orthopaedic problem. During the course of her stay in hospital, she encountered respiratory, cardiac and renal complications, yet she still remains under the care of orthopaedics. I have the utmost respect for orthopaedic surgeons, but they are not good at dealing with acute chronic medical problems. However, because of the way our hospitals are structured, this woman remains under the care of orthopaedics. She should have been moved to a medical ward and put under the care of a medical consultant. The structures in our hospitals do not allow that to happen. If a patient comes in under medical, he stays in medical; if he comes in under surgical, he stays under surgical; and if he comes in under orthopaedics, he stays in orthopaedics. There are too many barriers. That example may be simple for everyone in the House to understand but such barriers go right through our hospitals. There are numerous hidden Chinese walls that restrict the type of care that is necessary. The accusation has been made by many people that sometimes we have a health care system that is organised for those who work within it rather than those who use it. Perhaps it is a difficult conversation and perhaps not one that too many people in opposition are keen to hold before the general election, but I hope it is a conversation they will be prepared have after the general election.

See this speech in context