Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Acting Chair for his indulgence. I am a member of the housing committee, so I am learning to run from a committee meeting to the Dáil. Fianna Fáil has consistently argued for the restoration of the National Treatment Purchase Fund. This would reduce waiting lists and waiting times by referring public patients for treatment in private or public hospitals here, in the North or abroad. This could be done with the patient's agreement, taking quality, availability and cost into consideration. It worked in the past and can do so again. These dangerously long waiting times have to be tackled.

We are now in a situation where patients can wait up to 18 months in University Hospital Waterford to see a consultant about a hip or knee replacement. Patients who are in pain cannot endure this long a wait. This will have to change. I will refer to some figures for waiting lists I received this morning. Currently there are 4,426 people waiting on the inpatient day case list, which is slightly up on February, but up 53% since the Minister took over. I cannot understand why the waiting list in Waterford is almost double the combined total of all three hospitals in Cork. There are 223 people on the waiting list at Cork University Hospital, 162 at the Mercy University Hospital and 107 in the South Infirmary-Victoria Hospital, whereas in University Hospital Waterford there are 888 on the waiting list. That is a significant number of people impacted by waiting lists.

The setting up of the south/south west hospitals group in 2013 has been a retrograde step for University Hospital Waterford. Many people feel the hospital has been downgraded. Let us take the lack of 24/7 cardiac cover in Waterford and the south east region as an example. I have spoken about this already. Why are people living in the oldest city in Ireland being penalised? By providing cardiac cover only from 9 a.m. to 5 p.m. Monday to Friday, we are playing with people's lives. Why should these services be time sensitive in our region? We cannot put time restrictions on the emergency heart issues that people in Waterford and the surrounding areas might have. If a person in Waterford or the south east has a heart attack after 5 p.m. or at the weekend, they are dependent on a service in Cork. Mr. Bob Landers, clinical director at the HSE, has stated that best practice is cardiac intervention within 60 to 90 minutes. This is known as "the golden hour". However, this gives patients little hope when they have to travel between 100 km and 120 km to receive treatment. During the winter, with storms battering the country, the main road to Cork was closed for ten days due to flooding between Castlemartyr and Killeagh, with a diversion in place. The prolonged journey on country roads is not best practice for the patient or for the paramedics trying to work on a patient in the back of an ambulance. As first responders, the ambulance network and workers play a critical role in saving lives.

UK medical guidelines state that a cath lab should deal with a minimum of 100 emergency cases per year. Last year in Waterford there were 80 cases between 9 a.m. and 5 p.m, when the cardiac unit was open to the public. A similar number of patients - 77 - had to be transferred to Cork out of hours. This is a total of 157 cases. We clearly have the figures to support 24/7 cardiac cover. Are we being actively discriminated against? Why should it matter where a person lives? Are we being denied this treatment to maintain the skills of Cork and Dublin-based cardiologists?

I call on the Minister to review this situation. I understand this cannot happen overnight - we need a second cath lab and we need more consultants - but this could be rolled out incrementally. For example, it could be 8 a.m. to 8 p.m. to start, then 8 a.m. to midnight and finally the full 24-hour cover. This was not achieved or improved by the previous Government. I appeal to the Minister, if it is in his hands, to look at this again. We are playing with lives here and this has to change.

Another issue is mental health. Mental health issues continue silently to inflict immense damage on our country. The undercurrent of depression and anxiety is a major problem for society. No family is untouched by some form of mental health issue. The affliction of depression is exacting a hefty toll on the day-to-day lives of many people. People with mental health difficulties continue to experience significant social exclusion in Ireland and face difficulties like finding employment. People with a mental health disability are nine times more likely to be out of the labour force than those of a similar age without these problems. In child and adolescent mental health services the situation is more severe, with just over half the required staff in position. All too often we hear about children being placed in adult psychiatric units because there are not enough children's beds. Surely it only compounds the issue to place children in acute psychiatric wards where there are adults with serious issues.

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