Marc MacSharry (Sligo-Leitrim, Fianna Fail) | Oireachtas source

At this stage, the stones on the road know that we have many problems in our health service but what is needed is action. We are beyond the periodic outrage that we show in the House following an RTÉ programme or whatever local case some Deputy raises and we need to focus on tangible solutions. As far as I am concerned, our health service is focused exclusively on budgets by non-clinical personnel. That is wrong. As Deputy Kelleher noted, it is not focused on patients but on budgets. There are layers of management. I do not want to be critical of individuals who are setting out to do their jobs as best they can but the reality is that the level of autonomy and management that needs to be given to clinicians is not being given so far. Yes, we have decimated the numbers of personnel through the recruitment ban during the years of the crash.

We have taken thousands of beds out of the system and we need to focus on this. The €20 million allocated to the National Treatment Purchase Fund for this year is insufficient. I appeal to the Minister to make contact with the Minister for Public Expenditure and Reform before the day is out. There should be an emergency Cabinet meeting if necessary because many hundreds of millions must be allocated to the fund if we are to truly begin to deal with the problem.

We also need to focus heavily on capacity. How many times do we need to hear Fergal Hickey on the national airwaves saying, in his expert opinion, that extra acute beds are needed? Many Deputies have pointed out ad nauseamthat we need to relax the means test on the carer's allowance so that we can capitalise on the goodwill of people to care for elderly people at home and to give them the dignity to remain at home. This needs to be backed with a freer availability of medical cards, housing adaption grants and other supports. There needs to be more clinical autonomy in order that GPs can deal with things like mild trauma by having instantaneous access to diagnostics, meaning we do not have to take up acute beds with people waiting for CT scans, MRIs and so on. We need to focus on retaining and attracting staff.

Despite the individual best intentions of those involved in management and administration in the health service, it is dysfunctional and does not work to the extent we need. We need to strip out layers of management. I spoke to a group of nurses this morning and they told me conditions are worse than 25 years ago. That is unacceptable. We need less debate, less outrage and less manufactured shock and horror from RTE programmes and the stories we hear in our clinics. Tangible action needs to be taken.

The message I give to the Government today is that €20 million for the NTPF will not cut the mustard. It will need €100 million, and maybe more, to eat into the problem while stripping out layers of management and retaining and attracting more staff. I have no difficulty with managers who do their best but we cannot run our health service like a business. It is not a business but a service which costs money to run. It should be non-profitable but this is difficult to achieve. When there was a matron and a county surgeon the janitor, the consultant, the nurse, the GP and the patient shivered in their boots when they walked along the corridor. The buck stopped with them but nobody knows where the buck stops any more.

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