Mattie McGrath (Tipperary, Independent) | Oireachtas source

I too am delighted to be able to contribute. Like other speakers, I wonder what would have happened if we had the election nobody wanted but which almost arrived. Where would it have left us in respect of this Bill? It is being debated at half past the 11th hour - on the second-last day of this current session - as we head towards a new year. I think it is imprudent and improper that it is being stuck in here at the end of session given the huge and important amount of money being made available for appropriations across all Departments. This is not the right way to do business.

The former Taoiseach, Deputy Enda Kenny, made a promise during the talks. The Minister was there and was listening to him. He said that we would have to change because of the new situation arrived at after the election and the new scenario that had presented itself. He said that the whole public service would have to change to match that. I believe he was genuine, but we have not seen this change. The wheels of State are still turning as if there had been no change and no election. I am not attacking the officials but this whole system must change.

We have the Business Committee, which the Ceann Comhairle does a fine job of chairing. We worked very hard to set it up as a result of the work of the Sub-Committee on Dáil Reform. On that committee, we do our best to deal with any legislation that comes forward. I received an earful from the Minister for Transport, Tourism and Sport, Deputy Ross, a few minutes ago. One would think I was in control of the Business Committee. I am only one member representing our group. I am not preventing his legislation passing Second Stage. The Minister's comments were very unfair but I can deal with that when I am speaking on the Road Traffic (Amendment) Bill 2017. This kind of legislation comes through the committee and did so this morning. We agreed on it but anything could happen. The sky could fall in or the election could have happened. Where would we have been then? Would there be any money in any accounts to pay anybody in different Departments? To use other parlance, we are sailing close to the wind.

The amounts involved here are staggering. As the Minister of State said, in 2016 Ireland ranked sixth out of all OECD countries for per capitahealth care spend. Given the scale of gross voted expenditure of an estimated €14.8 billion in 2017, a key challenge is to ensure value for money to maximise the impact of the increased expenditure. The health budget has increased every year since I was elected, apart from the years when there were very serious cutbacks, but the outcomes have got worse. There are some very good outcomes when people get into the system, which all Members acknowledge, but there is chaos in terms of accident and emergency departments and waiting lists for simple operations on knees or hips or ophthalmic and cataract treatment. My colleagues, Deputies Danny Healy-Rae and Michael Collins, have organised for a busload of people to travel to Belfast this Saturday to get their cataracts treated on foot of an EU directive. Some of those people have been waiting four or five years for treatment. It took exposés by RTÉ and TV3 to get people to understand the sheer scale of the waiting lists. The EU directive exists but we are told it could disappear if Brexit goes ahead in all its incarnations and the UK ceases to be part of the EU, which would be a tragedy for Ireland. People have to organise the treatment themselves and most funding is organised through credit unions, which I thank. The treatment must be paid for upfront but people will get the money back from a health budget. I am told it will not come from the current budget and I would love to know from which one it comes. There seems to be endless money available. There was a response within five weeks. Many people cannot afford the treatment. I salute those Deputies for organising that endeavour. Buses will also travel up to Belfast in January and February. This is a great initiative and is made easier by the good motorway. Those people are delighted that they will be able to read the newspaper and see their crops, their loved ones and so on. They are nearly blind. We are happy to appropriate money into health to allow for such ventures.

Members are aware of the exposé in regard to consultants who work very limited hours. Many eminent consultants with whom I deal are very good but there are many, as was revealed, who conduct private business in public hospitals. Barry Desmond of the Labour Party - I am not sure whether he is still alive but I hope he is - was a Minister when I was only a buachaill óg and fought against the practice of consultants in the 1960s and 1970s working in public hospitals and using State-provided equipment. That should not have been allowed. A vet, dentist or any other practitioner has to have his or her own equipment, surgery, X-ray machine and equipment. Why should the State provide money for some consultants who earn enormous sums? While such consultants generally treat people well from a professional and medical perspective, some of them believe they are mighty people and treat others with utter disdain. At times, patients are barely permitted to talk to them. Why should the State provide them with assistance?

The outcomes in health have become worse. A line has been crossed. As regards orthodontic treatment, there are teenage girls in Tipperary who want to go to secondary school and are embarrassed to be out in public but have to wait four or five years for treatment. There are not enough psychologists available in the HSE. There is no mental health service in Tipperary, which is one of the finest and biggest counties in Ireland and which has a significant population. It has had no mental health services since A Vision for Change was implemented. It should have been called A Vision for Horror. People from south Tipperary and as far north as Thurles are expected to go to Kilkenny for treatment while people from north Tipperary are expected to go not to Limerick but, rather, to Ennis, where the mental health facilities are completely full and patients from Tipperary are not wanted. There are no facilities for transport for business, which is very important, as Members know, in the context of a person suffering from depression or mental illness. If a person has a psychotic episode, he or she ends up in the already vastly overcrowded accident and emergency department system.

We are coming up to the capital review of expenditure for the next period and more money will be thrown at hospitals without getting any meaningful outcomes. The Minister yesterday announced that HIQA will now have powers to close hospitals. Where will people go after hospitals are closed? Where will people go for treatment if we shut any more hospitals that are overcrowded and bursting at the seams? We can appropriate all that money and it is lovely to talk about the vast amount of money available and many good things are happening but there are also many bad things and much dysfunctionality and no accountability within the HSE.

Money is being thrown at the housing problem. All Members know how many housing Ministers there have been in recent years. Although it is Christmas and I do not want to be too hard on her, Deputy Burton will remember that when her colleague, Deputy Kelly, was housing Minister he promised to build skyscrapers to the moon that were going to be completed in weeks, not months. We saw very little action in that regard.

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