Joan Collins (Dublin South Central, Independent) | Oireachtas source

I thank the secretariat, the Trinity College team, the chairman, Deputy Shortall, and all my colleagues on the committee. There was an arduous 11 months of work on this report. I voted for the report in the committee despite the fact I believe it does not go far enough. Other Deputies think it goes too far. I will continue to support it and I will fight for its implementation in full. Like other Deputies, I do not wish to see the report left to gather dust because the political will to implement it does not exist. I do not wish to see it cherry-picked and turned into another set of so-called reforms of our health services. In fact, it would add to the existing mess of an unfit-for-purpose system if it were cherry-picked. This report comprises a set of moving cogs and if one part is put in place the other part must be set alongside it.

Our health service is a broken system. Other Deputies have mentioned various areas but I have had to represent people who are dealing with the urology department in St. James's Hospital. An 84 year old woman told me that she had been referred by her GP to the urology department and she received a letter saying that she would have her appointment in four years' time. She asked me if the department was waiting for her to die rather than serve her illness. I followed it up with a parliamentary question and discovered that there is only one consultant in the urology department. The other one left a year and a half ago. There are approximately 1,300 people waiting for outpatient appointments in that department in St. James's Hospital. That is an outrage. It shows the stark reality of what is happening in many hospitals throughout the country.

I support this report for one simple reason. Its main recommendation of a single-tier universal health service paid for by general taxation would, if implemented, represent a huge step forward in health care and in the provision of public services generally not only for patients but also for staff, doctors, nurses, GPs and community services. It is long past time that we dismantled the expensive and unfit-for-purpose jumble of private and public bodies, State bodies, charities, religious bodies and non-governmental organisations that we have inherited since the Victorians and established health care as a citizen's right, not an act of charity. This report is moving towards that. It is progressive in that way. I welcome the objective in the report to separate the public and private systems. This is a fundamental step towards a single-tier universal service.

A crucial part of the report is the implementation office and bringing in a person to drive the report's recommendations. If that does not happen, there will be a problem. The report requests that this be examined in July. It will be a first step to see the Minister for Health doing that. It will send a message to the health service that he is serious about the report. Then it will be necessary to go to the hospitals to explain what it is about and what we are trying to do, and to go to schools to explain to young people why we want them to go into training and to college so they can work in our hospitals and in our general practitioner and primary services.

However, a major failing of the report, and it was a bugbear for myself and other Deputies, is the issue of sections 38 and 39 bodies. Section 38 bodies are 100% funded by the State, so they should be in full public ownership and management. It is unacceptable that the new maternity hospital, to be built by the State at a cost of €300 million, whose 4,000 staff are paid for by taxpayers and which will be 100% funded by the State when it is up and running, would be under the ownership and management of a religious charity trust. This question has been raised in the Dáil by Deputy Shortall and others over the last week or so. The Minister must address it. It should be under the auspices of the public service and the HSE.

St. John of God is another section 38 institution. It provides services for disabled people and people with autism. We saw the horrendous situation where the chief executive officers in that institution were receiving money under the table and having their pensions propped up while services in the institution were affected by austerity. I have a copy of a letter from the mother of a child in St. John of God which she sent to the board of St. John of God when she heard and saw what had happened there. She says:

It is with great sadness and anger that we wish to inform you of our decision to withdraw our monthly donation to St John of God.

Our youngest son, Joseph, has been a pupil in Islandbridge for the past 3 years. Due to budget constraints, Joseph has never been seen by a therapist (speech or OT) since he joined the school. Joseph is 16 and his fine motor skills are such that he cannot hold a pen and write. He cannot read either. The teachers are doing everything they can to help Joseph develop and learn but the school lacks funds and access to therapists is operated on a priority basis. Joseph is not considered a priority and we would agree with this judgment. However, while we agree that Joseph may not need urgent access to therapists, we believe he needs help and could achieve much more if granted access to regular therapy.

The letter concludes:

We all make good and bad decisions. Most of us hope that the bad ones have limited implications for others. Most of us hope that the bad decisions will not break the trust, love and support we receive from those around us. Others have no such concerns.

The families whose children are attending St. John of God have been absolutely devastated by what has happened while the services they need so badly are not available.

Nursing homes and home helps are big issues as well, but we could not deal with everything in the report. These areas should be examined. We have been told that reviews in these areas are taking place. I hope we will be able to feed into that over the next period of time.

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