Catherine Connolly (Galway West, Independent) | Oireachtas source

I understand what the Minister is trying to do with this Bill. It is to be welcomed within the restricted criteria.

Insurance companies should not be able to pick and choose the age group or what illness they will treat. Within that restricted area, I see what the Minister is trying to do but it will certainly lead to hikes in premiums.

One cannot discuss this Bill without putting it against a background. Since the day I came into the Dáil, I have raised the Galway situation, not parochially, but as an example of what is happening to our public health system. I am disappointed in the Minister, even though he is not that long in office. I have repeatedly drawn this to his attention. Let me preface my remarks by saying I firmly believe in public health. I agree with previous speakers who have argued we are subsidising the private system. We have been subsidising the private system during my entire life as a local councillor and in sitting on the health board since 2006. Every single initiative from this Government, the previous Government, the Government before that and, in particular, the Fianna Fáil-PD Government was to subsidise the private system in every way possible. This was particularly the case with regard to councillors rezoning land to facilitate private hospitals and with regard to initiatives like the National Treatment Purchase Fund, which channelled public patients into the private system and accounted for a substantial amount of the profits made by the two private hospitals in Galway, in particular the one at Doughiska. Without that public money, that private hospital would not have made a profit.

I was tired tonight and was not going to speak on this Bill. However, I could not miss the opportunity, on behalf of the people of Galway who have elected me, and those in this country who believe, like I do, in a public health system, to keep putting pressure on the Minister in regard to private health insurance. I feel for those paying private insurance because they really believe they have no choice. It is based on fear, not on privilege, although they seek a privilege. All of us holding insurance seek that privilege to get quicker access but I do not blame people for that, such is their lack of trust in the public system.

Practically every week for the last seven weeks, the nurses in Galway have pointed out that the hospital is on code black. Code black is the highest level of warning in regard to what is happening in Galway hospital, which is known as a centre of excellence and looks after a region with a population of some 1 million people. I will give some figures to make a general point. On 11 November, there were 52 patients on trolleys and a 13 hour backlog was reported in the emergency department. At 4 p.m. that Wednesday, a 90 year old patient had entered her 80th hour on a trolley waiting for a bed. Staff were operating out of a single cubicle in the department to deal with life and death cases as all other cubicles in the 12 unit facility were taken up by patients in a queue for the wards.

I raised this with the Taoiseach last week but his reply made no sense. I actually printed out the reply to see whether I was mistaken but he made absolutely no sense when I asked him to step outside the rhetoric and bland assurances and deal with the crisis in Galway. The reply he gave is on the record and it made no sense. On that day I noted there was a full capacity protocol in place every day in the Galway hospital and code black. At the time I raised the issue, four people required access to the resuscitation room. In other words, there was a queue and a waiting list for resuscitation in Galway hospital, a centre of excellence which serves counties Donegal, Roscommon, Galway, Mayo and other counties. Elective procedures and cancer clinics are cancelled on a regular basis. Somebody who has an appointment on a Tuesday might get a phone call on a Friday evening. Irony of ironies, a warning was given out, stating: "Please only attend the emergency department in the case of emergencies."

Savita, as we know, died tragically at the end of 2012. Subsequently, recommendations were put in place, including additional staff. Since then, two senior midwifery experts have resigned and the statement from Saolta was that it was concerned. We have no idea what has happened in that regard. On 15 October Galway Bay FM newsroom stated:

A review has been launched at University Hospital Galway after an amputation was performed in a general ward yesterday. Medical protocols normally require that amputations take place under sterile conditions and under anaesthetic in a scheduled theatre. Saolta says it cannot outline the circumstances of the incident due to patient confidentiality but it has confirmed that the incident did occur on Friday.

The report referred to an inquiry but I am not sure where that inquiry rests at the moment.

Why is this happening? It is because there has been a sustained running down of the public hospital in Galway and other public hospitals in this country, while at the same time there has been a sustained investment in private hospitals. It is quite extraordinary that the Taoiseach was in Galway lately and he said he would visit the hospital when he had time. Prior to the election, he described the accident and emergency unit as not fit for purpose. The leader of Fianna Fáil described it as not fit for purpose. Post-election, the Taoiseach said he would visit it when he had time. Fine Gael had time to visit Galway and open a new wing, new ward or new something in the private hospital in the last 14 days but it did not have time to go into the public hospital and witness at first hand what is happening.

I understand a presentation was made today to the committee in regard to the need for a new hospital. I have repeatedly asked the Minister and the Taoiseach about a new hospital for Galway, and I have been told repeatedly, including in a bland reply on 12 July, "There are no plans for a new hospital to be built in Galway". I have raised this consistently since then. To be fair to the Taoiseach, when I raised it on 9 November and asked about a new hospital, he replied:

The Deputy has asked me to confirm the status of a new accident and emergency department and a new hospital. A new accident and emergency department was built at Wexford hospital, which is in Deputy Howlin's constituency.

That is the beginning of his reply. He then talked to the Ceann Comhairle because, naturally, I was being a bit obstreperous after a reply like that about Wexford. He next told us: "There are no trolleys in the emergency department at Wexford hospital." I do not know what the Taoiseach was saying. I think he was speaking English but perhaps the Minister can translate it for me. In any case, that was the reply.

I have asked on this consistently since I came into this House. The reason I have done this is, first, because of my own personal experience with family members, second, due to my experience as a local councillor sitting on a health forum consistently asking four questions every two months and, third, because finally last year the clinical director and the manager of the hospital said a new hospital was essential. They said the lack of capacity in the regional hospital was the No. 1 risk factor on their risk charter. That urgency of a new hospital in Galway was repeated today in the presentation to the committee.

I do not know how often we have to say it. Unfortunately, I will be coming back to a further investigation that has just been completed in Galway in regard to another very serious matter that has arisen in addition to the ones I have mentioned and in addition to the case of Savita Halappanavar.

To make a general point, I think we in this Dáil are all lessened if we do not have a public system for everybody.

If our health services are based not on need but on ability to pay or to have private health insurance we are in serious trouble as a civilised society. I have seen no attempt, apart from the committee which we all agreed to set up, to examine the health service in any urgent way or to commit to a public health service based on our taxes that will provide the service based on need that we all deserve. Private insurance should be for private hospitals and for those who wish to have a special room or suite. We want a first class health service and not to go from crisis to crisis and not to channel public money into the private system as we have done consistently, and not clap ourselves on the back for putting €20 million or €30 million into the National Treatment Purchase Fund. I have watched that and the special delivery unit and have kept a close eye on the profits of the private hospitals based on public money. I appeal to the Minister to visit the regional hospital in Galway, not to see the accident and emergency unit, which is a symptom of the overall problem of overcongestion on an overcongested site, in respect of the car park and the services. Every good doctor down there has admitted that and despairs of the constant talk of the crisis there. I appeal to the Minister to commit to the planning of a hospital on the 150 acre site in Merlin Park, which is a stone’s throw from the regional hospital.

He should commission an immediate and urgent report on what staff are necessary to provide a public health service in Galway. In the past two weeks patients were scheduled for procedures related to kidney stones and other problems but because the theatre was closed the consultant in charge gave the patients the option of going in his car to the private hospital for the procedure. They willingly took him up on this and went in his car to the private hospital and returned to the public system in an ambulance and were discharged. They were delighted.

I have no idea what the Minister has done since I asked him about the building of a new hospital. He assured me he was meeting management which came out publicly today to say what was said months ago about the need for a public hospital and the fact that the regional hospital is not fit for purpose. As a result, the staff are under enormous strain and mistakes are being made. I will return to this point next week. Can the Minister hear that? It would be something to hear it and it would be marvellous if he committed to a public health system and private health insurance for private hospitals if that is what people want. We should have a public health system provided by our taxes and the Minister should take on board that the regional hospital in Galway is not fit for purpose and that is not just the accident and emergency unit.

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