Mattie McGrath (Tipperary, Independent) | Oireachtas source

Following this week's budget, we now have spending of €14.6 billion on our health services. That is a huge increase. It is almost 20% of total spending by this Government of taxpayers' money. We have one of the highest health spending ratios in the OECD but we continue to have some of the worst health outcomes. I acknowledge that there are many excellent outcomes and very good practices going on in our hospitals daily, but huge issues remain. The Minister's experience and that of the Minister for Public Expenditure and Reform, Deputy Donohoe, who tried to divvy up the funding with the Minister for Finance, Deputy Noonan, means they understand the process. It is a headache. A sum of €500 million was already added in October by the Minister for Health, Deputy Harris, whom I wish well in his post. Now €490 million is to be added to that.

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That is almost €1 billion extra this year, on top of an extra €1 billion last year. There is no accountability. Unfortunately, our outcomes are not improving especially at our accident and emergency departments.

St. Joseph's Hospital, now called South Tipperary General Hospital, in Clonmel is a small hospital when compared nationally. It consistently has 30 or more patients on trolleys every day. The front-line staff are under enormous pressure. A long time ago, when the Minister, Deputy Noonan, was the relevant Minister, when there was agreement to amalgamate and move to Clonmel, we spent €20 million to upgrade Our Lady's Hospital in Cashel to a magnificent state-of-the-art facility and it lies idle. There are no lights on and the doors are closed except for some small activities during the day. It makes no sense.

Why do our citizens have to beg for home help? People with intellectual and other disabilities have to beg and have to deal with HSE bureaucracy. There is something really bad with the bureaucratic system of the HSE. It is past time for this to be tackled. We need to get accountability and proper standards, and we need care for our citizens. That is a very basic right: we are not in a Third World country.

Why are 24 year old mental health patients forced to lie in a psychiatric ward when they should be treated in the community? Mental health services were taken away from Clonmel without putting community services of any value in first. We are making these decisions.

As we speak, in Clare and north Tipperary there is a review of our first responders and ambulance services following the closure of accident and emergency departments in Nenagh and Ennis. Now these will be taken away from us. We have Civil Defence and Red Cross ambulances trying to bring people to hospitals, augmenting the service of the HSE.

I am asking the Minister, who is an experienced Minister, and his colleagues in the minority Government to deal with the layers of management in the HSE. We have 35% more managers in the HSE now than we had in 2007, right at the beginning of our crisis and all the suffering that went on. We have terrible outcomes and scandals such as the recent one with drug payment overcharging by a company, which just paid it back and nobody was held accountable. We need accountability in the HSE. I am demanding that the Government do it. The people want accountability but are not getting it. There are too many issues with people waiting for orthodontic treatment and everything else. There is no proper accountability or transparency.

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