Jackie Cahill (Tipperary, Fianna Fail) | Oireachtas source

I wish the new Minister and Ministers of State the best of luck in their portfolios. I welcome the allocation of an extra €500 million for health services.

As a representative of County Tipperary which no longer has a Government Deputy or Senator, I will focus on the lack of mental health facilities in the county. With a population of 160,000, County Tipperary does not have psychiatric beds, while the clinic in Thurles is under-resourced. For example, it does not have an occupational therapist; a psychiatric counselling service is not available and it is only open from 9 a.m. to 5 p.m. five days each week. This means taht people from the north of the county must travel to Ennis to avail of care, while people living in the south must travel to Kilkenny. This issue must be addressed and I look forward to the Government making proposals in that regard.

The Minister did not provide detail on how much funding is being provided for home care services and home care packages. Two completely different policies on managing home help hours are applied in north and south Tipperary, respectively. The service in south Tipperary uses its entire allocation of hours with HSE staff and thereafter employs agencies, whereas the service in north Tipperary uses a combination of HSE staff and agencies throughout the year. A consistent approach is required because the use of different approaches in the same county is preventing the system from operating efficiently. In any case, the service requires more funding if an adequate service is to be provided for those who need it most.

The HSE practice of offering home help hours in half-hour segments must be addressed as it is not an efficient use of resources. It is certainly not satisfactory for the service user and employees of the service.

I would like to know if any of the additional funding will be used to tackle the ever-increasing numbers on waiting lists. The numbers on the inpatient and day case lists have increased by almost 50% in the past two years.Figures for May this year show that 509,994 patients are either waiting for an operation or an outpatient appointment. The number waiting for an outpatient appointment has increased from 407,257 to 415,584 in the space of one month, while more than 62,000 of these individuals have been waiting for more than one year. In addition, the backlog of patients who need surgery increased from 74,274 to 74,986, having stood at 50,000 in 2014. This is an increase of approximately 50%. Last year’s targets are being missed, with more than 5,000 waiting for surgery for more than 15 months in May. This is a significant jump when one compares it with the figure of 4,603 who were enduring the same delay in April.

The figures also show that the number waiting in excess of 18 months for an outpatient appointment to see a specialist increased from 8,570 in April to 13,095 in May. Of those waiting for surgery, 4,704 are children, 58 of whom have been waiting for more than a year and a half. More than 60,000 people, including more than 4,500 children, have been waiting for more than one year for an outpatient appointment.

As a first-time Deputy, I find that the annual merry-go-round of health budget overruns followed by the introduction of a Revised Estimate smacks of poor planning. It appears that the HSE runs the service until its budget runs out before being bailed out by the Government. Surely a budget should be presented for a 12-month period. In every year since 2011 the HSE has required a substantial supplementary budget. Given the ad hocapproach to health planning and changing demographics, does the Minister agree that we are storing up major problems for the future? The population grew by 23% in the past 15 years and is set to grow by a further 30% in the next 25.

The 65 to 74 age group is set to grow by over 33% and the 75 years plus age group is set to grow by an incredible 82%.

We need careful planning to ensure the health service, which has come in for extensive criticism in recent years, does not run into even more trouble in the coming years. Deputy Healy referred specifically to South Tipperary General Hospital, Clonmel. Some things could be done in Tipperary which would not cost a great deal to the HSE budget. Our Lady's County and Surgical Hospital, Cashel, is fully furnished but its doors are closed. It must be re-opened as a set-down facility. The Dean Maxwell facility in Roscrea, a residential home for elderly people, urgently needs investment and more beds are required. Mount Sion in Tipperary must be kept open as a residential home for people with mental illness and the Community Hospital of the Assumption in Thurles also needs more investment and capacity.

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