Michael Fitzmaurice (Roscommon-Galway, Independent) | Oireachtas source

I am grateful for the opportunity to speak on this Bill. For the past few years when new insurance companies moved into the health sector elderly people were treated differently because of their age and young people got away lightly. The insurers were taking the low-hanging fruit, which would not cost them. Something had to be done to regularise that but the levy for an ordinary family on an average wage struggling to pay a mortgage, compared with the levy a millionaire pays is disproportionate in terms of the type of cover each can afford. That needs to be examined.

Many people use the private health service out of fear. Any person with young children will save their last few euro to make sure their children are not waiting in accident and emergency departments for a full day. They scrimp to give their children something they may not have had and out of fear that something may go wrong. The Minister is not long in his job and nobody is going to wave a magic wand in the health service overnight and solve the problem which has been going on for years. I know from talking to the Minister that his heart is in the right place. Whether in the private or the public sector until we take on the hidden agendas in the health service we will never solve it. Sometimes people involved in the health service speak out of both sides of their mouths and that is difficult for any Minister. Until somebody faces them down and sorts this problem out I cannot see it being solved quickly no matter how many of us speak in here. There are plans afoot for the primary care centres to do more. Machines around the country are lying idle because someone disputes whether they should work or double shift or work late at night. In private hospitals X-rays are done at 11.30 p.m. or midnight. This is where they win. I come from a sector that constantly uses machinery. If a machine is bought and there is a big backlog of work whatever resources are needed are brought in to work triple shifts if necessary to make sure the backlog is taken away. We can talk till the cows come home but unless something like that is done and people work with everybody it will not be solved.

Health insurance costs go up every year and people cannot afford to pay more every year. Where is efficiency coming in? Where is the joined-up thinking? With the amount of money that goes into the health service we should have a gold plated service but unfortunately with the way it has been mismanaged many people are, sadly, left in a bad way.

The headlines every day in Ballinasloe and Galway are about the chaos in the accident and emergency departments. We have to consider people who may unfortunately have cancer and have to travel 300 km each way from Donegal to Galway on bad roads. There is no joined-up thinking to find a solution maybe in Sligo or in Altnagelvin to help them. Let us think of a wider area and make sure those people will not have to make the harrowing journey to Galway. I am fully in favour of centres of excellence. I am not saying we should be going to every place in Ireland but surely there is some way of bringing sick people fewer than 300 km each way to get the help they need.

For every Deputy in this Dáil, both Government and Opposition, there is a young child born that needs special attention. There is great work done. Let us not condemn everything. Once one gets inside the system, there are great consultants, nurses, doctors and others. Phenomenal work is done by those people. However, getting in those doors is the big problem. Unfortunately, whether it is a heart bypass, a hip replacement or another treatment, Merlin Park is the same. In the last fortnight, I saw youngsters for whom an X-ray machine is needed as they require dental work. The machine was broken. In fairness, a new one has replaced it, but the backlogs are not being dealt with. We could spend money and subcontract the work out to the private hospitals under the National Treatment Purchase Fund. We could do something like that for a while to get rid of those backlogs. There are an awful lot of youngsters that need to be seen, be it for dental work or ear or eyesight issues. There are many elderly people who are suffering day in, day out with knees, hips and different things that need to be treated.

There is a problem with health insurance. There is one aspect that is not in the average run-of-the-mill policy that would enable someone to prevent a problem happening. If one wants to go for a medical, one must pay for it out of one's own pocket. If insurers were forward-thinking and trying to save themselves money, there would be some system or initiative that would allow people in their 40s or whatever to have a medical every year or two years to make sure of their health down the road. A stitch in time saves nine. A lot of expensive treatment can be saved if something is identified on time. I would urge that something like that is brought in to insurance.

There is another issue I would like the Minister to address, although obviously he will not be able to address it in this Bill. In the commitments in the programme for Government, there is a review of the helicopter service. I saw last week that the health service in Northern Ireland is after getting a helicopter in memory of a doctor, I think. It is my firm belief that two helicopters are needed in the Republic of Ireland to make sure that there are options for those areas that an ambulance is unable to get to within the designated time. I believe that should be moved forward as quickly as possible. The Minister is six months in the job now. I would love to hear him say tomorrow that he is starting that review, because we need it. No matter where one lives, whether it is three hours from an accident and emergency department, like some people in Roscommon, or right beside one, everyone deserves the same health care and treatment.

I know there is congestion in many of the hospitals at the moment. As Deputy Connolly said, it stands to reason that if an accident and emergency department is closed down, more people are obviously going to go to other hospitals. Whether it is Ballinasloe or Galway, traffic congestion and parking are major problems. Thankfully, Roscommon hospital has become very busy with what has been put into it. However, there are serious problems with parking around Roscommon hospital. At the moment, people going to the hospital are actually parking up at the Hyde Park GAA pitch. This is not an ideal situation for elderly people who may be going into the hospital for an appointment. It is not suitable and it needs to be addressed.

I know a review is being carried out on mental health services. Unfortunately, that review which will include Roscommon mental health services has not come out yet. I would welcome that being published. We have had difficulty in Roscommon. I do not know whether Ministers did not know what was going on or whether the HSE was not telling them. The new system has patients living in the community, which everyone agrees with, provided the patient is fit to live in the community. Unfortunately, instead of contacting their families, giving them a liaison officer and the right to say "no", patients in certain parts of the country are being pushed out into the communities. That is not the way to treat the people. The way to treat them is to work with people and their families to make sure the health service is doing the very best for them, and not telling them where they are going and wrecking their minds day in, day out. This is especially true for people who are vulnerable. What went on in the last six weeks in our area with some people is intolerable. We had a meeting with the HSE and, in fairness, it seems to have started to listen to what we have said over the last couple of weeks. However, it is no good in the HSE telling the media it is doing something when Deputies on all sides of the House hear a different story about the situation from the people affected.

Another issue that needs to be dealt with is the rates charged and the costs. Bills that come back from hospitals, VHI, Laya or whatever insurance supplier one has are phenomenal. There should be some system to evaluate what it actually costs. One can get a hotel bed in Dublin for €100 a night. However, a hospital bed is €1,000 a night. I know that more equipment is needed and I understand all that, but, my God, there seems to be a serious problem.

I echo what Deputy Connolly has said about the chaos above in Galway. Nurses and doctors will tell the Minister that it is a place that no one wants to go. Some people would rather stay at home than sit in an accident and emergency department for maybe 12 or 14 hours, through no fault of nurses or doctors. Patients could be on trolleys for two or three days. This has to stop. There are ways of doing it. I know that the Minister has tried to solve the problem over the last few months with the winter initiative but there is a serious problem there. Perhaps the solution is step-down care for patients who would be fit to go to another place, be it a nursing home or a respite home for a few weeks. There are plenty of nursing homes in Galway and Roscommon that would be able to look after people.

The seven-day service in some of the category two hospitals was discussed in the programme for Government. I know that no hospital is being singled out as the Minister outlined that in the programme for Government. There are a few hospitals around the country that it relates to and I ask the Minister to speed up that process, because it could be helpful in solving the overall problem.

There is another issue that has not been addressed. If an elderly person twists his or her ankle in Dunnes Stores in Roscommon and ends up lying on the ground, someone might not know what is wrong with him or her and, out of the goodness of his or her heart, might dial 999. If someone dials 999 at the moment, the ambulance will have to go past the hospital that is able to cater for minor injuries and bring the person to the accident and emergency in Ballinasloe or Galway.

There should be a system in place to provide for greater discretion for paramedics, who are great people at what they do, and advanced paramedics at least should be able to make a call on whether a person really needs to go to an accident and emergency unit or if they could deal with them. If we keep putting everyone in the one place it is inevitable that the system will get bunged up. If a person needs an X-ray and he or she can go to a category 2 hospital that is what should be done, rather than an ambulance bringing a person elsewhere and then perhaps two hours later a family member going there to bring the person home again. That does not make a lot of sense.

If someone has a heart attack he or she needs to go to an accident and emergency unit or a hospital that can handle it, for example, University Hospital Galway, but if a person breaks his or her ankle then Merlin Park University Hospital should be well able to handle it. We need to ensure we are not bunging up the system with problems that could be sorted in other hospitals. Unless we do that, we will not solve the problem.

I understand the Minister is required to introduce this measure to ensure elderly people will be treated fairly, but I urge him to take on board what we have said. In fairness to Deputy Connolly or any Deputy from the west, sadly, we are aware of the amount of reports coming from Galway, although once people get into any of the hospitals then we hear good things. The accident and emergency unit in Ballinasloe hospital needs attention. We must ensure we keep that hospital working properly.

I urge the Minister to do what I asked him in terms of the items relating to Roscommon that are included in the programme for Government. Above all, I urge him to expedite the introduction of a helicopter service in certain parts of the west, not just in the constituencies represented by Deputy Connolly and me, but including Mayo, Donegal and the midlands. A lot of money is not being spent well. The money should be put into the provision of a 24-hour air ambulance service in this country not just for one section of it. I urge the Minister to examine the issue. I will support the Bill. Go raibh míle maith agat.

See this speech in context