Michael Collins (Cork South West, Independent) | Oireachtas source

The "RTE Investigates" programme on Monday night was heartbreaking to watch but, unfortunately, the stories told sounded all too familiar to me. Countless constituents have come to me in similar situations: elderly people waiting up to two years to have cataracts removed, children suffering from increasing pain as a result of not having scoliosis treatment and cancer patients being given appointments that are later cancelled at short notice.

The 2016 Euro Health Consumer Index, EHCI, has ranked Ireland as the country with the worst waiting times in a comprehensive study of 35 countries. This is totally unacceptable. I agree that our health service is not underfunded but badly managed. We have been told that €900 million more has gone into the health system this year compared with last year, yet we do not see any results. This view was confirmed by the EHCI study, which found that Ireland was also the fifth worst country for efficiency, or "bang for the buck". Accountability at all levels is required. The Irish health system has been late to introduce technology, which has inhibited the ability to properly track an individual's interaction with the health service. The top place in the EHCI study is held by the Netherlands, ahead of Switzerland and then Norway. Uniform procedures for data gathering are needed. The improved management of waiting lists requires an understanding of the relationship between the demand for a service and the rate of supply. This understanding requires the development of information systems which can not only record the numbers of patients waiting for admission, but also enable demand and supply for particular services to be monitored.

We fail to take care of the little things, such as paying highly-prized nursing staff a fair salary and providing even simple things such as parking. Too many nurses spend their days performing routine tasks such as form-filling rather than clinical activity involving patients. Following changes to consultants' contracts, the only way many medical posts can be filled is by allowing doctors to work privately. This gives us doctors who work part-time in the public system and do not have any great commitment to it. We have too few beds and too many rolling closures of operating theatres. Operating lists do not start on time, they are inefficient and they finish at 4 p.m. or 5 p.m. In the private sector, they continue until the work is done. We need a tough Minister to effect change and one or two people in charge of the health system at the top. I do not buy the constant call for more resources; we need to make the present system work better.

We need accountability from management, which faces no real sanctions for underperformance. The system has been badly hurt by the cutbacks of the 1980s, 1990s and from 2009 to 2014 and has not fully recovered. We have fewer hospital beds than in 1980, while the population has grown by one third and the older population by twice that. We have too few hospital beds; we need more. We do not need capacity reviews to tell us this, though they might tell us where the extra beds should be. We also need more doctors, particularly specialists – perhaps up to 2,800 extra. There are new layers of management and there is less engagement with general practitioners than before. The system is not listening to GPs enough. There is unstable employment for nurses. There have been up to three nursing pay cuts since 2009, coupled with an increase in their working hours of six hours each month.

I have no doubt but that the Minister has an incredibly difficult task but I truly believe the system is not working. Action is required immediately, not down the road. We should consider the state of our hospitals. Many hospitals, such as Bantry General Hospital, are well able to carry out brilliant procedures but their accident and emergency services were closed overnight. People such as me, community people, were told at the time that we were scaremongering. We were not scaremongering. We now have the evidence of all these cutbacks.

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