Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I will confine my remarks to the issue of health, although I appreciate that the Minister for Health is not present. I am sure that he will make it his business to acquaint himself with Sinn Féin's position, unlike the Taoiseach, who did not fully understand it.

No one in the Dáil or anywhere else will contradict me when I say that we are in the middle of a health crisis. This is not just something that Sinn Féin says. Rather, it has been acknowledged widely by people outside and inside the House. As such, the manner in which money has been allocated in the budget beggars belief. The money for the health service represents an underfunding, which is being done in order to ensure that the priority of tax cuts can be achieved.

I was shocked by how regressive the health section of the budget was. I almost did not know where to start when trying to put my thoughts together. The Irish Medical Organisation, IMO, put it best by calling it deeply disappointing and regressive. The IMO also skewered the claim that this was somehow the largest health budget ever and rightly stated that that was nothing but spin and fake news. I would not thank President Donald Trump for much, but I will thank him for giving us the phrase "fake news" because it saves us from using other terminology. We all know what "fake news" is. It is spin, it is bluster, it is bluff.

The IMO came to its conclusion for the same reasons that we in Sinn Féin did, namely, the budget will not even keep pace with rising health demands or health inflation and the crisis will worsen. Yesterday's budget announced an extra €685 million for the health service for 2018, but it needs an extra €691 million next year just to stay afloat. That is the true nature of this budget. When faced with a choice between increasing investment in the health service to make it fit for purpose and cutting taxes, Fine Gael and Fianna Fáil chose tax cuts.

Nearly 700,000 people are on hospital waiting lists throughout the State, but the Government's response is to allocate €55 million to the National Treatment Purchase Fund, NTPF. This is an increased allocation of scarce public sector resources into what is essentially a private sector fund. That money will no longer be available for the public service. It will not be available for those people who need investment in the public service the most. Instead, it will be diverted into the private sector. It will not reduce waiting lists to any great extent. I will not ask the Government to take my word for this, but the word of Dr. Sara Burke, a well-known health policy analyst. Her analysis of the NTPF's impact shows that, while we get a small short-term gain at best, it makes no meaningful or appreciable difference.

The prudent and practical measure of directing this money into the public service, which has the staff, equipment and ability to perform all of the procedures in question from the complex to the straightforward, should have been prioritised in the budget. Instead, the money has been diverted into the private sector. This is the source of most of my concern. Not only will public funds go into the private sector, but our nurses, doctors and other qualified health professionals and health workers will follow that money into the private sector and out of the public service. It is clear that the Fine Gael plan is to realign the health service from a public service to a private for-profit model. Nothing else would explain the budget's measures.

What was there in yesterday's budget for the 549 patients on trolleys?

9 o’clock

The Irish Hospital Consultants Association and the Irish Association for Emergency Medicine have stated that people die because they are left on trolleys. The €50 million for acute services has been split so many ways I have lost count. I have lost count trying to keep track of the many ways this €50 million will be spent. What the health service needs is for the beds that were closed to be reopened immediately. That is why Sinn Féin proposed investing €153 million to open 500 beds. That is a very clear target and a very clear statement. It includes staffing theatres and labs, non-clinical staffing and other running costs to address capacity issues. The measures announced by the Government in budget 2018 make a mockery of the seriousness of this situation.

Let us look at our older persons. Care delivered in the home is the preferred option for most older people. They want to stay living at home with dignity and respect and to live independently for as long as possible. What has the budget really done for their health needs? One of the selected measures, which the Government has put up in lights, is that there will be €32 million for funding for older people. That is to cover delayed discharges, care pathways and transitional care beds, as well as 45 additional home care packages per week to be issued during the winter. Those 45 home care packages per week will add up to around 675 packages. This will hardly address even the current state of unmet need never mind cater for those who will go on to need home help and home care. Our older persons are not getting their hours as it stands. There is not a Deputy in the House who does not have constituents coming to him or her saying they have been allocated a certain number of hours but they cannot actually access those hours. We have shown how we can increase home help hours by 20% resulting in 2.1 million additional home help hours and we have shown that home care packages can be increased by 15% which will mean 2,485 extra home care packages. Such meaningful investment in our older people would go some way to delivering for them and their families and ensure they can live with the dignity and respect they have earned.

In mental health, the Government repackaged old money and announced it as new. When one breaks it down, what was delivered was €15 million. That is not even new wine in old bottles. It is no wine at all. That is nothing for the mental health budget. It is an insult to people who are desperate and watching the budget to see if they will get any respite. The answer is they very definitely will not. Mental Health Reform has expressed extreme disappointment at the shortfall in the budget for mental health. Ireland's mental health services are under severe pressure, yet we see in the budget the big plan is to implement A Vision for Change, a ten-year strategy that is now 11 years old. It has not been implemented up until now and I am not confident it will be.

The Minister for Finance announced an additional 1,800 front-line staff in our health service. I would welcome it but unfortunately I am hesitant to do so because the latest census figures show that out of the 1,000 additional nurses promised as per the agreement with the nursing unions and the HSE, we see 13 additional nurses within the health service. That is 13 out of 1,000. Where will the Government get the 1,800 front-line staff from? How will it convince these people to come and work in our health service? Dr. Rhona Mahony, giving evidence to the Committee on the Eighth Amendment of the Constitution this morning, said we are already 140 midwives short, yet we see in the budget an announcement that the maternity strategy will be implemented. We do not have the staff to do this. The National Association of General Practitioners, the IMO, the Irish Nurses and Midwives Organisation, INMO, and all the organisations that represent staff within the health service have absolutely slated this budget for exactly what it is. It will fail people. It will not address the health crisis but it will put money into the pockets of those in the private sector. It will leave people on trolleys and on waiting lists. It will leave our elderly people in a desperate state where they do not know where they will get their home help hours from. As a consequence of the budget that was announced yesterday, our health service will be worse this time next year.

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