Michael Harty (Clare, Independent) | Oireachtas source

It is disappointing that this debate is only for statements to be given rather than a debate on which Members can vote. That was explained in the House yesterday by saying that last year there were only statements on this issue rather than a debate and the same formula is now being followed. However, last year statements on this issue were made after 30 June when the legislation had been renewed and consequently there was no point in having a debate. It is disappointing there is to be no real debate this year. The debate last year took place in early July if my memory serves me correctly.

The legislation urgently needs to be reversed because the financial crisis is over. I agree with Members who have said that the legislation is being carried on for reasons other than a financial emergency. It is and was draconian, similar to that which would be introduced during wartime rather than a financial crisis. It has been overplayed and needs to be reversed. It appears from the Minister's speech that this will not be done until 2020, which is far too distant. It has enshrined unequal pay in the public service.

Pay equalisation is urgently needed. It is a huge issue for nurses, teachers and gardaí. It feeds into the recruitment and retention of essential staff and services because unequal pay is driving people out of this country. Nurses and doctors, who can work anywhere in the world in a global market, are being forced out of this country because of unequal pay and the legacy issues of FEMPI. Many midwives are leaving the country or the profession because of their working conditions and the responsibility they are expected to take on and the unequal pay they receive while working alongside colleagues who are getting standard pay rates. FEMPI is feeding into the difficulty in recruiting and retaining staff. It has huge legacy issues going far beyond pay. This draconian measure is being continued long beyond the country's financial recovery.

FEMPI was disproportionately applied to general practitioners in an unfair and careless manner. GPs are paid a global fee, part of which is their income but a substantial part of which is the finances they are given to run their practices, yet FEMPI was applied to the entire fee. GPs have suffered a 38% reduction in the finances they get to run their practices. No small business could sustain such a reduction for more than a year or two, but for many years GP practices have been subject to that. It cannot continue. FEMPI is a principal cause of the huge manpower issue in general practice. There is also the issue of outdated GP contracts, as Members understand and has been discussed in the House on many occasions, but FEMPI has torn the heart out of general practice and made it non-viable. GPs cannot run a practice with a 38% reduction in their overall income year upon year. Therefore, they are retiring or emigrating to the Middle East, Canada and Australia. Young GPs are looking at how general practice has been destroyed by FEMPI and thus are not taking up GP lists. There is, therefore, a huge manpower crisis in general practice.

The Committee on the Future of Healthcare has spent 11 months producing the Sláintecare report, which recommends that there be a shift from hospital-centred care to primary and community-centred care. Who does the Minister think is going to deliver that service? To deliver the service recommended by Sláintecare would require 1,000 extra GPs. With the country's ageing population, it is crucial that there be a shift from hospital care to primary and community care. Demographics show that it will not be possible to sustain the health service unless chronic illness is dealt with outside the hospital system and looked after in communities and in primary and social care. A critical component of that strategy is the retention and recruitment of GPs. That cannot be done while FEMPI has reduced the amount of funding for general practices by 38%. GPs are effectively civil servants, and as eligibility for GP services is extended to greater numbers of the population and eventually the entire population, GPs will be fully paid civil servants and they cannot run their practices on an income that has been reduced by 38% by FEMPI. It has been disproportionately and unfairly applied to general practice in a very uncaring manner. I urge Deputy Donohoe, as Minister for Finance and Minister for Public Expenditure and Reform, to look at this issue specifically because our health care system is in crisis. It cannot continue in its current form. There must be recruitment and retention of general practitioners but FEMPI has torn the heart out of general practice. By not reforming our health service, we are being disingenuous and unfair to our population and to patients.

It is an issue of human rights now. The way our patients are treated in our health service is so poor. While many parts of our health service are functioning very well, there certainly are many areas in which the human rights of patients are being infringed on. FEMPI is a huge part of that and I urge the Minister to look at it in particular with regards to general practice.

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