Pádraig Mac Lochlainn (Donegal North East, Sinn Fein) | Oireachtas source

I have listened to Deputy Twomey and other Government colleagues for the past while. I know that Deputy Twomey is a general practitioner and has experience of the primary care system. I share his concerns. We watched the documentary about sugar, about the increase in diabetes and about lifestyle. These issues have been on the table for many years. The only difficulty I have is that one would think the Government Deputies had just taken up office for a couple months and were asking us to give them a chance to see what they could do. However, they have been in power for five years.

What we have had is a case of chronic underinvestment in the health services. The chief executive of the HSE told a Sunday newspaper that the whole thing is up in the air. The Minister, Deputy Varadkar, knows that the issues are about chronic underinvestment. Let us discuss Letterkenny General Hospital, which has been linked to University Hospital Galway as part of the Saolta hospital group. It is simply not working. I was speaking on radio in Galway some days ago about some of the numbers relating to University Hospital Galway. The Minister will be aware that there are patients right along the west coast up to the top of Donegal who are being referred to the hospital in Galway. The inpatient and outpatient waiting lists in that hospital amount to 40,000. The inpatient and outpatient numbers waiting for more one year come to 5,000. Despite this, patients are being referred there from as far away as north Donegal. It is utterly stupid. Clearly, the necessary investment has not been put into the hospital.

Let us consider the hospital in Letterkenny which is serving a population of 160,000 in Donegal. There are 15,500 on the waiting list for that hospital, including 1,500 who have been waiting over a year. Now, because the Government has not invested in the public hospital there, the HSE must refer people to private hospitals on both sides of the Border. This does not make economic sense. Since the Government has not recruited enough consultants and doctors, it has to hire locums and, in some cases, pay them two, three or four times more than it should be paying them. What the Government is doing does not make economic sense.

I have spoken to senior people in the hospital in Letterkenny. It has been my hospital for many years. The only way I can describe their opinion is to say that they are in despair over what is happening to our hospital. It is our people's hospital. It is where our children are born and where our loved ones die. It is an integral part of our life, as it is in every other hospital in every community throughout the State. We have seen what has happened there. The number of inpatients going through Letterkenny amounts to more than 20,000 per annum. Despite this, we have had the lowest allocation of budget and staff of any hospital in the State.

We have now been linked into the Saolta hospital group. At the start, the people to whom I spoke in the hospital entered into the process with an open mind. They thought things could not get much worse. As I said to the Minister, a year or two on they are in despair. It might do the Minister no harm to meet the clinical directors and senior consultants in some hospitals, have a cup of coffee with them and ask them to speak to him off the record about what is happening. His eyes would be opened.

My local hospital is Letterkenny General Hospital. There are two permanent surgeons to cater for a population of 60,000. To run a 24-hour accident and emergency department in a hospital, a full coterie of consultants and specialties are needed to meet demand. There are locums, who are linked to two permanent surgeons. The Minister will recall that the consultant urologist, Mr. Kevin Moran, had to resign in despair in the early part of 2015 due to the lack of resources available to him.

As the Minister knows, urology is at the heart of cancer care services. Only weeks later, a breast cancer surgeon, who also, like Mr. Moran, carries out other surgeries throughout the hospital, spoke on a local radio station and said he was on the verge of doing the same as Mr. Moran. It was a crisis. The Minister facilitated a meeting in Dublin. It was a good meeting thanks to the fact the consultant, Mr. Michael Sugrue, attended the meeting, told everybody in the room to cut their nonsense and described the reality of the situation and what was needed. We put in place a number of solutions. Some seven months later, they have not been implemented. The Saolta hospital group is all over the place.

As I said, the issue is chronic underinvestment and a lack of doctors, medical staff, budgets, beds and capital. The same applies to the community hospital and primary care infrastructure in communities. All that has a knock-on effect. The Minister knows why we have an accident and emergency crisis. Sinn Féin worked hard over a long period to consult all sorts of experts to come to the Minister with the constructive proposal we have put to him. It is about investment because there is no other way around the issue.

The solution involves examining the fiscal space of €8.6 billion over the next five years. We would allocate €3.3 billion and recruit an extra 6,600 front-line staff because that is what is required. We would move the health service, on an incremental basis over a period of five years,from a two-tier system that is clearly unjust and in crisis to one that is universal. We have outlined our plan to the Minister and, more importantly, to the people.

The people will soon decide on their Government for the next five years and whether it comprises those on this side or the other side of the House. I am interested in the comments of the Minister. He said if he took on the role of Minister for Health again and the people decided that was the way to go, he would like to have the budget and, what is interesting, the authority to do what needs to be done. Frankly, that is a load of nonsense. The Minister clearly has the authority, but the Government has not invested and put in place the resources required. Instead, we have heard the same nonsense today as we heard before about structural issues, staffing issues and things needing to be sorted out. The problems are always blamed on the system or the HSE when the core issue staring us in the face involves resources. We have given the Minister and the people a plan and that, and nothing else, is what will be required to turn this ship around.

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