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

The continuing inequalities in public health are a direct result of the deep social and economic divisions in our society, with the wealthier sections enjoying better health and speedier access to health care compared with the less well off. This should be intolerable in Ireland in the 21st century, yet pervasive social and economic inequality, now as in the past, continues to generate poverty and ill health in Ireland.

In health care, Sinn Féin’s primary goal is a new universal public health system for Ireland that provides care free at the point of delivery, available to all on the basis of need alone, and funded from fair and progressive taxation. As a party committed to equal rights and equal opportunities, we have on a number of occasions presented our policy priorities to achieve a system of universal health care in Ireland and have offered solutions to the crises that present every day in our health services.

One particular area of health care that deserves to be mentioned is mental health. Mental health is a key area in which successive governments have failed to provide an adequate level of service. This is despite that 644,000 people, one in seven adults, have experienced a mental health difficulty in the past year. While there have been attempts to reconfigure health spending and ensure mental health care is prioritised, we see funds earmarked to mental health spending being spent in other areas.

A number of weeks ago, I recorded my concerns that with a quarter of the 2016 calendar year now past, the promised additional €35 million to be spent on mental health had not yet been released. I also highlighted that in the absence of the means to hold the Minister, Deputy Varadkar, to account in the Dáil Chamber, I was prevented from carrying out my electoral mandate as a representative of the people.

It appears that the situation has gone from bad to worse with the threat of €12 million being taken from the additional €35 million which was ring-fenced for mental health.

This is absolutely deplorable and is indicative of a Government and senior Civil Service that is out of touch with the realities faced by so many who suffer from mental health issues. I echo the criticisms of Mental Health Reform, which rightly points out that there is no parity of esteem between mental and physical health. Sinn Féin has a plan for mental health care. Among our proposals are a commitment to increase the mental health budget in year one by €35 million, to complete the roll-out of suicide crisis assessment nurses, to reverse cuts to guidance counselling in schools introduced by the Government in 2012, to increase the number of inpatient child and adolescent beds and to increase the number of child and adolescent mental health service, CAMHS, teams.

The Trolley Watch figures provided by the Irish Nurses and Midwives Organisation regularly highlight the impact of decades of Government failure to adequately provide for the sick and the vulnerable. Yesterday, 323 patients languished on trolleys. The crisis is partly a reflection of inefficiencies within the system. Not all hospitals discharge seven days a week, for example, but in the main, it is directly due to lack of capacity in terms of staffing and bed numbers. There is also a shortage of exit packages, including the provision of home help hours and home care packages, and inadequate numbers of long-stay nursing home beds. We need to increase the number of hospital beds available in the system to move people from trolleys into wards. We need to recruit more nurses into our emergency department and acute hospital system. Many young Irish people want to become doctors, nurses, surgeons or dentists. They go to college and study for years in a system that grows more expensive by the year. When they graduate, they are faced with a health system ravaged by years of austerity, recruitment embargoes and funding cuts imposed by the Fine Gael and Labour Party Government and by Fianna Fáil before it. For too many, the choice is plain, and emigration is the result.

If we are to stem the flow of doctors, nurses and others from our health system and attract those that have already left to come home, we must commence sustained action to address the single biggest factor influencing medical migration - the toxic work environment that currently prevails. Ad hoc, half-hearted recruitment drives will not cut it. To foster and maintain a productive and motivated medical workforce, we must put credible light at the end of the tunnel for staff, showing that things will get better and stay better. This requires a commitment to ambitious multi-annual recruitment targets with revenue allocated to back these up.

As far back as the 2001 health strategy entitled Quality and Fairness – A Health System for You, there was a commitment that "by the end of 2004, no public patient will have to wait for more than three months to commence treatment, following referral from an out-patient department". We could not be further away from that if we tried. Last week, data from the National Treatment Purchase Fund revealed that hospital waiting list figures have increased for inpatient, day case and outpatient care. It revealed that an astonishing 490,500 patients - nearly half a million people - are awaiting treatment or assessment in the public hospital system. This is utterly shameful. In January, it was reported that 250 children with scoliosis were waiting for an operation to fix their spine or waiting to see a consultant. Many of these have been waiting for 15 months or more for this vital treatment. This continues to be the case. I recently learned of a child who has been waiting for rod surgery since 2014. He is only four years old and needs the rods to stabilise his spine. The little boy was due to have surgery at the end of April but this has now been cancelled again and moved to May. Without this surgery, the curve in his spine continues to progress. This causes breathlessness, infections and pressure on his heart and vital organs. I have been informed that an operation was carried out recently on a child with a 100-degree curve of the spine. That is just cruel.

New waiting time targets were introduced by the Minister for Health in mid-2015 but, rather than trying to solve the problem, he simply shifted the goalposts, extending the waiting time target from 12 months to 18 months in an effort to salve the damning statistics of his failures. No serious effort was ever made to achieve these targets, and waiting times have grown since. The waiting list crisis is one of access, capacity, funding and resources. In order to address this situation, we need to increase the capacity of the hospital system by recruiting the necessary staff, opening further beds and investing in care in the community.

What Sinn Féin advocated and what over 295,000 people voted for in the recent election was a plan to end these scandals once and for all. Our fully costed health policy demonstrates in a very pointed fashion how an ambitious multi-annual recruitment plan and, ultimately, an investment of €3.3 billion will bring sufficient capacity into our health system. The election took place eight weeks ago this Friday. We are still without a Government. No Minister has come before this Dáil to address these urgent issues or to be held to account for what is happening under his or her watch, and today simply does not tick the box. It would appear that there is absolutely no appreciation of the distress and often pain that those awaiting access to our hospital services and those on trolleys are enduring. This has to stop. Inadequate increases in the overall health spend will not hack it. The crises in our health services of which we are aware will assuredly deepen if significant additional moneys are not approved and released to tackle the serious under-capacity that exists. I urge all who will be a part of whatever Government arrangement emerges from the current round of talks to put health care at the top of their list of priorities.

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