Catherine Connolly (Galway West, Independent) | Oireachtas source

I welcome the opportunity to contribute to the debate. I deplore the fact that we did not receive a briefing document earlier. I understand from a telephone message I received that the document was only made available in the past hour. That is not a way to deal with this. The Minister is shaking his head but I will not use my time on this other than to record that we did not receive a briefing document as should have been the case. We should also have received a copy of the Estimates before yesterday.

I would like to raise a number of issues. I welcome the Revised Estimate but it is a drop in the ocean for a health system that is creaking at the seams because of previous decisions. The word "ideology" has been used in the debate. I am no ideologue; I am a practical woman when it comes to services. I believe in a public health service funded by taxation and the vast majority of people want that. It makes sense even on an economic level and I will outline a number of examples form the documents that have been circulated. I would like the Minister to stop referring to elderly people as a burden. Perhaps he might be doing it indirectly but the language in his documents states that elderly people place an increased demand on the health service because of an ageing population. I would like to balance this comment with a few figures. Only 4% of our elderly are in nursing homes and a further 5% receive home care services. The other 90% of elderly people live independent lives. It was established that the elderly make a substantial contribution in terms of spending and taxation to society in England following a costing that was done there recently. We should get away from looking on the elderly as a burden and consider the talent and the money they contribute.

Reference is made to stroke on page 24 of the briefing document. I welcome the positive statement on the improvement in services for stroke victims. However, Professor Harbison, the clinical director in respect of stroke at St. James's Hospital, has made figures available through a newspaper article and they are worth examining. They outline what the failure to implement the national stroke strategy is costing the State. He pointed out that an amount that is less than the amount proposed to be spent on two new drugs over five years has been spent on the strategy. Strokes costs the economy €500 million annually but at least 50% of them are preventable. This year alone, 8,000 people will suffer a stroke, yet six of our acute hospitals do not have the most basic requirement, namely, a special ward or unit for the treatment of stroke. Professor Harbison stated, "Despite the successes, we still have huge deficiencies in stroke care in Ireland", with only 40% of the stroke unit beds required. Currently, only half of stroke patients are treated in special units. That is a clear example of where money could be saved and then put into education and prevention and proper treatment in order that stroke victims would spend less time in hospital. They would spend less time taking up beds if money was invested in order to provide appropriate care in the home.

A total of 140,000 children live in consistent poverty. We have a major housing crisis and, yesterday, I outlined literacy figures. All those factors contribute to an unhealthy society and lead to people having to avail of health services, which would not be necessary if basic homes were provided for our people and if problems relating to illiteracy and alcohol were addressed.

In the briefing document, one page is given over to mental health services. The document does not refer to the cost to the economy of the failure to treat patients who are mentally ill. I use these figures deliberately because this is a debate on the Estimates. A Vision for Change was a revolutionary document published in 2006. I am reluctant to quote one figure it contains - the figure is incredible - because it must be a mistake.

Extrapolating from the Northern Ireland figures, it is said that the cost to the economy for the failure to treat mental illness is more than €11 billion per year. I use that figure very carefully but if the cost to the economy is anywhere near that, do we not have a serious problem due to our failure to treat mental illness appropriately? There is no mention in the Revised Estimates of a review of the mental health strategy, A Vision for Change. No timespan is given for that. The period of time that plan covered expired in January of this year and it is now June. I do not see a reference to where that review is at. During that ten-year period, there was an inbuilt mechanism for monitoring progress and the independent monitoring group, along with the Mental Health Commission, repeatedly pointed out that the implementation of the mental health strategy was both inconsistent and tardy. The then Government's response to that was not to have a third implementation body, so it sat for two three-year periods and was then disbanded. The mental health vision set out has not been monitored and we have actually gone backwards.

During the many very sensitive debates in this Chamber on mental health, suicide was mentioned, as were all of the problems that we have. I sat here in utter frustration simply because all those problems were identified in 2006. The suicide levels ten years ago were very acute. A strategy was clearly set out but none of it was implemented. As was said previously, when we hear the whirring blades of the helicopter in Galway, it means something completely different to us now as week after week somebody is taken from the water. The problems were identified as were the solutions to them. However, the solutions were not implemented.

With regard to hospital beds, I have watched the underpinning of the public health system since I was first elected, particularly since I was elected to a health forum in 2006. Certainly Fianna Fáil and the Progressive Democrats were responsible for that and certainly Fine Gael and the Labour Party followed suit. I hope this Government will change the direction and commit to a public health system funded from taxation. The Government cannot keep giving money to the National Treatment Purchase Fund, a special delivery unit and agency staff.

I would like to ask the Minister specifically about our obligation under the EU directive whereby if one can succeed in borrowing money from the credit union or any other credit establishment, one can go abroad for treatment. Where is that factored into the Revised Estimates? When we see all the money that is being allocated to agency staff, the special delivery unit and the National Treatment Purchase Fund and all the money going out of the country, would it not occur to the Minister or his staff to propose we put it into the public system and thereby increase the bed capacity, as we have a lack of intensive care beds and many doctors have gone out on a limb. Doctors have put their names repeatedly to letters to The Irish Timesand other newspapers begging for the bed capacity to be increased and for a very long time, we have had to listen to the mantra that we need fewer beds.

We have been told we cannot employ staff. Having had a depletion of our public health system and an embargo on recruitment, we now cannot find staff.We have not changed our recruitment system in trying to find staff. If we have spare money in the recruitment budget, could it go to Console, the Samaritans or to the other organisations that are literally saving people from the water? I listened with dismay to an interview where the director of mental health said she could not possibly spend that €35 million before the end of the year. I welcome the U-turn but should the Minister have any difficulties in the future in spending funds in the budget, will he come back to us? We will certainly tell him where it could be spent, and Console would be one of those organisations.

I will conclude on a final parochial note. We require a new hospital in Galway. I raised this matter with the Minister and he gave me a bureaucratic answer to the effect that there were no plans at the moment, and that is despite the fact the clinical director of the hospital in Galway said everything they are doing is a fire-fighting exercise and that the lack of capacity and the inadequacy of the hospital is the number risk factor.

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