Alan Kelly (Tipperary, Labour) | Oireachtas source

I thank Deputy Louise O'Reilly for raising this issue again. I agree with every single thing that has been said here tonight. I think we all do. There is political consensus that we have a crisis. I am not going to bother with the tit for tat political rubbish. We are in a crisis situation when it comes to health care. The problem now for us all is that it is like talking about the weather. Solutions do not arrive when there is a discourse that emanates and passes through people as a matter of form and norm. In the middle of all this, we have incredible people working in the service. We all acknowledge that. They are the best people one could ever meet. Like everyone else in this House, I have had to deal with them. All the stories we have told about people waiting and, of course, when people are in desperate straits they come to the likes of us and we try to help out. Incidentally, that should not be the way it works. I have had to do it myself on numerous occasions over the holiday period. It is at the stage now where, as politicians representing all the various views, we need to come together and pull together instead of pulling apart. We know what our strengths are: our resources and our people. We have significant decisions to make in the short, medium and long term.

I want the Minister to support the Sláintecare report. I welcome what he has done in respect of advertising the position at the head of it. I know he has commenced some of the reviews that were requested. The issue of private practice by consultants in public hospitals is something I was determined about as one of those who helped draft the report. I welcome all of that. That is long term. However, we are behind schedule already.

What are we going to do in the short to medium term? While the bed capacity review is critically important, I agree with Deputy Kelleher that it is one thing doing a report. How are we going to ensure that the stock arrives and quickly?

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I do not expect the Minister to wave a magic wand. It is impossible to wave a magic wand and have the beds appear. We need to identify where, in the short term, we can make beds available in hospitals throughout the country where there are wards and capacity. In the medium term, we obviously need a capital plan. I believe that everyone in the House will support the Minister in respect of the capital review and getting as much money as possible to deliver that.

Some 96 beds have been promised in a new unit in University Hospital Limerick. Limerick is on one side of me and south Tipperary is on the other. The two hospitals with the biggest accident and emergency department issues in the country are located in the area. It will be four or five years before the new unit is in place. What will people do in the interim? We need to be innovative and find solutions.

Everyone has spoken about demographic changes, people having greater expectations and all of that. Of course people have higher expectations because they are living longer and there are treatments now for many things which we could not treat ten or 15 years ago. Has it come to a stage in this country where in the case of a very simple issue, such as a double cataract, people are told they are lucky to get one eye done? That is the state we are in in Ireland in 2018. People are being told that they are lucky to have one eye treated, and not to be selfish and look for treatment in the other eye in case they could drive a car or go to work. It is incredible.

We need to change the way pathways are working across the hospital network and hospital groups. I wish to make one recommendation which could improve the situation in the short-term. Our ambulance service is under major pressure. I have raised this issue for years, as the Ministers knows, but I will repeat myself. There is no reason that intermediate vehicles cannot operate across hospital networks and transport people from grade A to grade B hospitals in order for them to be treated in step-down facilities or avail of aftercare treatment or monitoring. There are people in University Hospital Limerick rather than Ennis or Nenagh because there is no transport to move them. Sometimes vehicles are not available or do not operate. The same happens across the country. This is a low-cost solution and all of these things would help. People can be brought to Ennis and Nenagh, where there is capacity and wards could be extended or opened.

We all know what happened with regard to the Hanly report and other reports, whereby services were closed without adequate services being available in other hospitals. Let us not go down that road with Portlaoise. We also have to ensure that the pathways between hospitals outside networks are improved.

Last week, I heard about a young 12 year old boy who has liver failure. He was brought by his parents to University Hospital Limerick, and was then referred to a hospital in Dublin. Everything was supposed to be fine and a bed was supposed to be available for him in the hospital. However, when he arrived yesterday, it was not available and the family were told to come back at lunchtime and again in the evening. The bed was still not available and last night the family slept in a hotel. They went back to the hospital today and the bed was still not available. The family spent the day at a service station, with their sleeping child on the back seat of a car. He was sick and jaundiced. They waited for hours at the service station, hoping and praying that they did not have to drive to Limerick to get drugs for the child. They cried to me on the phone, looking for help to get into a hospital in Dublin. Luckily, after a lot of phone calls, the child got a bed in hospital tonight. The child was in the back seat of the car with his twin - they go everywhere together. That type of thing is not the practice we need in 2018 and is not an example of the pathways which work in this country. The pathways do not work. Children, of all people, should not be affected.

I have said to the Minister on numerous occasions that we have to develop more home help hours and home care packages. The simple fact of the matter is that it makes financial sense. Home care packages and home help hours keep people in their homes. It is cheaper and more cost effective than nursing homes or spending €6,000 to keep a patient in an acute bad. This is not rocket science; we just need to roll out such a policy as quickly as possible. There is an issue in terms of getting staff.

I wish to recommend long-term, medium-term and short-term solutions, because we have to come up with solutions. In the long term, we need a significant amount of investment on the capital side in IT because that will save money. In the medium term, the roll-out of home care packages needs to be enhanced and quadrupled. In the short term, I ask the Minister to examine transportation.

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