Michael Harty (Clare, Independent) | Oireachtas source

I welcome the opportunity to contribute to this debate. We have a minority Fine Gael Party-Independent Alliance coalition Government which depends on the support of the Fianna Fáil Party under the confidence and supply arrangement. As such, this is a unique budget, albeit one that does not have any surprises.

The budget could have been framed in a different way to secure maximum benefit. We still have legacy issues from the Celtic tiger era and we are in a period of international volatility arising from the Brexit decision. These factors have fed into the budget. I acknowledge also that the programme for Government cannot be delivered in one budget.

An additional €1 billion has been allocated to the health service. This is an extraordinary amount of money and while welcome, it must be spent in a focused way. If we are to solve the health crisis, we must address waiting lists and trolley counts. This will mean spending money in a focused manner. Recruitment and retention of staff is a critical issue because we are losing highly educated staff to other health systems as a result of poor working conditions in the health system, poor progression in postgraduate education and the poor lifestyle available to those working in the health service.

We need increased availability of beds, which does not necessarily mean making provision for more beds. Beds must be used in a much more efficient manner.

We must also increase the availability of diagnostics and ensure they are available seven days per week and at least 12 or 14 hours per day, if not 24 hours per day because patients are waiting in hospital for tests that are delaying their discharge.

Work practices must change and I am the first to admit that this includes general practitioners. The services and systems in operation in hospitals must change, as must hospital consultants, because some systems and practices are 40 years out of date. The health service has moved on and we must identify how to focus the money provided to the health service.

We must develop primary care because it will be the driver of the health system in future. Primary care is also the point at which most chronic illnesses and mental illness will be treated. It is critically important that it is integrated with hospital services.

It is unacceptable that patients are more worried about visiting a casualty department than they are about their health. People are wary of attending an emergency department in case they have to wait on a trolley. Some would prefer to be ill at home than visit a hospital to access services.

While I welcome the decision to recruit an additional 1,000 nurses, I wonder where they will come from given that the uptake under the recruitment drive of the past year or two has been poor. The conditions in which doctors and nurses work must be changed if recruits are to be attracted to the health service.

The provision of medical cards to 10,000 people in receipt of the domiciliary care allowance is an essential measure. As a general practitioner, it often troubled me to see people with severe disabilities who were not entitled to a medical card. This is great progress.

On the introduction of a monthly cap of €20 on prescription charges, the current prescription charge of €2.50 is too high. The prescription charge was set at 50 cent when it was introduced and acted as a disincentive to patients to take unnecessary drugs. However, it has developed into a tax collection measure and should have been reduced.

I commend the 50 cent increase in the price of a packet of cigarettes. This is an essential change because smoking is a major health hazard and the higher the price of cigarettes, the less people will smoke. Excise duty on alcohol should also have increased. We talk about heroin and drug addiction but alcohol is the most dangerous drug in society.

I welcome the increase in expenditure on homelessness, in particular, on mental health services for people on the streets who have alcohol and other addiction problems. We must try to get homeless people off the streets.

I am disappointed with the funding available for rural Ireland. Rural areas must become viable and sustainable. However, the budget does not provide enough to deliver sustainability. Balanced regional development is needed and in that regard I acknowledge the increase of €107 million in funding for the rural development programme. Other services in rural areas also require support. For example, broadband must be extended to rural areas. While I accept that the Minister for Communications, Climate Action and Environment, Deputy Denis Naughten, is working tirelessly on this issue, rural broadband must be delivered quickly. The programme must be accelerated. Unfortunately, it will take six years to roll out broadband nationwide.

We have major problems with the post office network. Pensioners may have received an increase of €5 in the old age pension but they have to travel ten or 15 miles to pick up their pension because their local post office may have closed by the middle of next year. Substantial investment is needed in the post office network and Government services should be devolved to post offices. In addition, a public community banking network must be established which can work through the post office network.

The budget was a missed opportunity to increase the capitation payment to primary schools, which are struggling to supply services. An increase in the capitation payment should be included in next year's budget. The proposed increase in the number of teachers will only keep pace with demographic changes and will not reduce the pupil-teacher ratio, which in some cases is 35:1. In that regard, the budget was another missed opportunity.

On agriculture, I welcome the step-out option being introduced in respect of income averaging. The changes in VAT as it applies to farmers are also welcome, as are the measures on the farm assist and community rural employment schemes. However, the real problem with farming is the price of milk and beef, and farmers must be supported in this regard.

I am worried the help-to-buy scheme announced by the Minister may increase the price of houses rather than enable people to buy a house.

Dealing with the price of constructing a house is the best approach to the housing crisis, whether by reducing VAT on houses, by reducing the cost of connection to utilities, such as water, gas and electricity, or by using public land for private housing, which will take the site cost out of the cost of the house. This approach to the housing crisis would be preferable to the help-to-buy scheme.

The universal social charge is obviously an unwelcome tax. However, a reduction of 0.5% is a minimal reduction and it takes €335 million to deliver it. There are many in this society who would prefer to see that €335 million spent on services, particularly health and housing services, because the take-home difference in their pay packet will be so minimal.

When listening to the Minister's speech, I wondered if FEMPI was going to be mentioned at all but it was mentioned on the second-last page. The unwinding of FEMPI is a hugely important part of recruiting and retaining staff. FEMPI has devastated incomes and is the single-most destructive tax in that it leads to the emigration of our nurses, doctors, teachers and engineers. It needs to be unwound rapidly and I hope it will be unwound in the next year. It has certainly been disproportionately applied to doctors in general practice, where we have taken a 40% reduction in the resources to run our practices. FEMPI is extremely important and I would like the Government to keep it in mind.

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