Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I thank all Members who have contributed during the course of today's debate. The Minister, Deputy Varadkar, made reference in his contribution earlier this morning to the budget 2016 commitments of the Opposition parties. He made false claims regarding his and his Government's budget 2016 commitments. I note that he acknowledges that Sinn Féin and Fianna Fáil recognised in the preparation of our pre-budget alternative submissions the crisis in the emergency departments and each provided €86 million to address measures needed this year. Fianna Fáil, as it does, rounded it up to €90 million. Nevertheless, we had provision within our alternative address of the crisis. The Minister went on to say it fell short of the €117 million the Government provided in 2015. It was the budget for 2016 that we were preparing. He goes on to mention "the further significant funding we are providing this year". What further significant funding is the Government providing this year?

3 o’clock

It does not show at all in budget 2016 announced by the Government in October. In fact, in the summary of the new expenditure measures that was presented in the Dáil by the Minister for Public Expenditure and Reform, Deputy Howlin, there is only €18 million in additional funding provided in budget 2016 for children's health and therapeutic services, totally ignoring the real crises that exist.

The Minister, Deputy Varadkar, states that my party's proposals on general practice would render some GP practices unviable. Contrary to the Minister's claims, we have real and substantive proposals for addressing the shortage of GPs and their current difficulties, and that is the issue the Minister is clearly missing. It is important to take on board that we propose increasing the annual training intake, from 161 to 200, to facilitate the growth in the number of qualified GPs. We want to broaden the attractiveness of general practice as a career choice. We want to see 200 salaried GPs brought in as a new measure, with support staff in the form of additional medical secretaries and 200 new practice nurses, in tandem with those specific practices being located in the areas of the country that are currently underprovided for, these being large swathes of rural Ireland and some deprived city areas throughout the State, not least in Dublin city.

I welcome the Minister's acknowledgement that our policy proposals, in terms of my party's new health policy launched before Christmas, contain good ideas, but he went on to state that they "would require a level of investment that is just not realistic". That is not so. Our policy is not only realistic but a no-choice situation. No doubt the Government wants to cut core taxation and put more excess spending power into the pockets of the already well-off. We want to ensure such investment is made instead in quality public services, and let the Minister be in no doubt that health and health care is Sinn Féin's No. 1 priority.

The Minister went on to state that "Sinn Féin's approach to policy is almost childlike". If that is the Minister's view, it is because the proposals we present are straightforward and uncomplicated and will work. The Minister went on to state that my party would put €5 billion into health. As it happens, over a five-year Dáil term we would increase spending on health on the base year of 2015 by a total of €10.5 billion, commencing with €794 million in 2016 and rising to €3.3 billion in the fifth year. These are important commitments.

The Minister, as highlighted by Deputy Kelleher, did not read into the record all that he had been offered. My point is he talks about developing plans recognising the range of difficulties. For heaven's sake, we all know the range of difficulties. It is the plans to address them that we want. The Minister seems to be averse to long-term thinking and I would ask him not to spend too long at it because it does not appear to be something at which he excels.

On the issue of the 30 days he has chosen to cite the statistics on the trolley watch figures, I repeat that there has been an increase of 21% in the position regarding the trolley and ward watch from January to December 2015 compared with the same period in 2014. For the record, there were 443 patients on hospital trolleys this morning, a very serious matter indeed.

On the provision for older persons, the Minister states that home help hours and home care packages were strengthened last year and will be maintained in 2016. We do not only want to see 2015 figures sustained in 2016; we need expansion. As our motion clearly states, we want to see a 10% increase in the expenditure on home care packages and home help hours, with a €31 million commitment in year one rising to €93 million over a three-year period. Those are the sort of serious measures that will address the problems that we currently experience.

On the position in the nursing home support scheme, the Minister speaks of an increase of €35 million on last year's so-called projected spend. It is interesting that the Minister chose such phraseology. What was the actual spend? Is there any increase at all on 2015? We, on the other hand, have committed to spending at least an additional €125 million to create the necessary additional bed capacity that will help to address the current situation of delayed discharges and the need for people to be able to access long-term care provision and to have the alternative of remaining in their home if it is safe and appropriate to do so.

The Minister stated that in January 2015 he set maximum waiting times for inpatient and day case treatment and outpatient appointments of 18 months by 30 June and 15 months by the end of the year. Of course, the Minister was increasing it to facilitate an easement in terms of the public focus on his failures to ensure the waiting times were being met. The Minister increased it to massage the figures. Let there be no doubt about it, in case there is any, that the situation as of the beginning of this month with inpatient and day case national hospital waiting times is that there are 746 waiting more than 15 months and 5,665 waiting more than 12 months. On the outpatient situation, there are 9,887 waiting more than 15 months - those whom the Minister promised would by now no longer be waiting more than 15 months - and over 12 months, a not unreasonable target to address, there are 37,197. Of course, the overall position is outpatients: 375,440, and inpatient care: 68,086.

I note the Minister concluded his remarks with, "I can assure the House of my ongoing commitment and interest ... and that of the Government". I wonder about the Minister's interest and I wonder what he was referring to in relation to the Government. Was it their ongoing commitment or was it just their interest? In the Government amendment, the Minister stated that "timely access ... continues to be a primary focus of Government policy", but what about Government action? Government policy is all very well; it is only on paper. What we want is the evidence that the Minister has a commitment to do it. What did the Minister actually mean by the phrase "Health will never be a good news story"? Why will health not be a good news story? Of course, it needs to be a good news story.

When we look at the Minister's 88 actions in addressing the ongoing difficulties within emergency departments, we should take a look at what he talks about. Not enough has been done on increased bed capacity in hospitals. Clearly, not enough has been done either on reducing delayed discharges from hospitals. On recruiting more medical and nursing staff into the health service, again not enough has been. I will not go on with the rest of the list but let me tell the Minister in unequivocal terms that his end of term report card clearly shows that he has failed.

See this speech in context