Brian Stanley (Laois-Offaly, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak on this motion. I heard Deputy Buttimer state that we spend just over €13 billion on health per year. That is wrong. That figure refers to the amount spent on health from the tax take. The Deputy did not include the money that is paid in private health insurance and out-of-pocket expenses to pharmacists, consultants and a range of other services. Several billion euro more is spent on health. The Minister and Deputy Twomey will know, as doctors, that a large amount of money is paid in out-of-pocket expenses, apart from what is allocated from the general tax take. When all the money is added up, one will find we have the second most expensive health system in the world, second only to America.

Deputy Twomey referred to obesity. I saw the television programme featuring Dr. Eva Orsmond on Monday. I got somebody to record it in order that I could watch it. The programme shocked me. I thought I was doing well, but it was an eye-opener in terms of sugar intake. Those returned to Government might look for clearer labelling of food. Even with my glasses on, often I cannot read the labels on supermarket shelves when doing the weekly shopping. Labels on food are not clear in terms of how much sugar and additives are in the different processed foods we buy, something which needs to be addressed.

Sinn Féin is putting forward a comprehensive health policy. We know there is no magic wand and it will take time to deal with the situation. It will bring to Government terms to bring us towards a universal public health system. Nothing short of that is what is needed. It is a way of solving the crisis.

There is major concern locally regarding the Midlands Regional Hospital, Portlaoise ever since the leaked departmental report in 2014 which recommended that 24-hour accident and emergency cover be reduced and the number of beds limited to 20. That would be a major blow to a hospital where 38,000 people go through the emergency department. It is the second busiest such department outside of Dublin. As I pointed out when the report was leaked, rather than reduce the level of services, extra resources are needed. We need full-time permanent consultants to be appointed to the emergency department. Where will patients go if the hours are reduced or the department is closed? Tullamore and Naas do not have the capacity. Tallaght hospital is chock-a-block. I spoke to Deputy Crowe about it before I stood up to speak. There is nowhere to send patients.

At the time the report was met with significant opposition and a further report, which was to be commissioned under Dr. Susan O'Reilly, was to be issued in September, but so far we have not seen sight nor sound of it. We have now been told that will not go to the Minister but has gone on a detour and has been taken to an official in the Department or HSE. The Minister might update us on the status of the report. Has it been delayed in case it causes political difficulties for Fine Gael and the Labour Party in the run-in to the general election?

The Minister has been less than reassuring. I raised this issue in June, at which time he praised the hospital emergency department and staff for their efficiency and assured us there was no question of it being closed. However, he stood over doubts raised within the Department as to whether 24-hour services could continue in the hospital. I hope the decision is not being held back because of potential negative electoral consequences for the Labour Party and Fine Gael.

When I asked whether it was intended to employ a number of consultants and to continue the 24-hour service, the Minister was vague. Despite referring to the large numbers passing through the emergency department, he said any decision would take account of existing patient flows. There is major concern locally about this issue.

There are two doctors on the other side of the House. Some 43 GPs sent a letter to me and other public representatives yesterday. They have said they are disappointed that the draft action plan which was due to be published, that is, Dr. Susan O'Reilly's report and plan following consultations in September, has not yet been published. They are concerned that the delay is due to a political agenda. They said they are very concerned about the situation, which is similar to Roscommon, and that in the aftermath of the general election the same situation will arise in Portlaoise.

They went on to say that they are aware that the future of the 24-hour emergency department remains at risk and that future services may include a 24-hour paediatric assessment unit and a 24-hour acute medical assessment unit. They said they do not believe that such departments can be run safely in the absence of a properly resourced 24-hour emergency department, that such a model is risky, unsafe and potentially dangerous, and that they cannot support it.

They said any reduction in the opening hours of the emergency department would add significant pressures to the GPs trying to practice in the area and the already burdened MIDoc out of hours service. GP posts in Laois cannot be filled and there is a shortage of GPs. The GPs state it cannot be pushed back on them because they do not have the resources and there are not enough of them. I have outlined why patients cannot be sent to Tullamore or Naas, because they do not have the capacity. I am not having a pop. I am just outlining what the staff in the hospitals tell me and others and what the GPs say. These people are in the same position as Deputy Twomey, who is also a GP. They state closing the emergency department at Portlaoise will only ensure unsafe services and they will not support it. They believe the only viable solution to ensuring safe services is the retention and appropriate resourcing of a 24-hour emergency department. This was signed by 43 GPs in the county.

There is huge concern beyond the county. There is concern in south Kildare, Offaly and North Tipperary. The mothers of the on average 2,000 babies who are born there every year come from these areas. I appeal to the Minister in the short time that is left-----

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