Dáil debates

Tuesday, 16 January 2018

Leaders' Questions

 

2:00 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

Over the recent period, the number of patients on trolleys in our accident and emergency departments has broken all records and fairly and objectively represents a damning indictment of the Government's lack of planning in respect of this crisis, its lack of urgency, its lack of prioritisation of a phenomenon that has caused significant distress to many patients and families throughout the country, and much more. The Irish Association for Emergency Medicine reasonably asked how many more patients would have to die needlessly while inertia prevailed. This is in a context in which it is estimated that 350 to 400 deaths per year are directly attributable to emergency department overcrowding.

This situation is interesting, given what happens in Scotland and England. In Scotland, just 6% of patients waited for longer than four hours. In Ireland, 19% of patients waited for longer than nine hours, which is a considerable difference. In England, commentators describe people waiting longer than four hours as a shocking lapse. Ms Susan Mitchell recently put it well in her article in the Sunday Business Post, which stated: "What passes for inexcusable in Britain would represent a huge improvement for the Irish health system."

Three years ago, the Taoiseach as Minister for Health said that he was "sick to death" of the problem and that he would solve it once and for all. He referenced a long-term plan to solve it. Three years on and that plan has never materialised.

As we know, the situation has become much worse since that announcement by the Taoiseach. This reflects a continuing unacceptable approach, a fundamental lack of urgency in respect of this issue and, sometimes, an attempt to normalise it. The toleration threshold relating to people waiting in accident and emergency departments is simply unacceptable and too high. The level of complacency is shocking.

In terms of some of the Government's own metrics and targets, the capital provision is woefully inadequate and does not provide for any meaningful response to the awaited bed capacity review. On the GP contract talks, we have been told for the past two or three years that something would materialise but it has not. Nothing is happening. Community intervention teams have not been established and providing diagnostics in the community is another aspiration. There is a lack of home support and so on and the crisis is all round. The budget is passed in October and the HSE's service plan is published in late December. There is an absence of transparency in the lead up to the budget. The Government takes it on trust that adequate provision will be made for acute services but that never materialises.

Does the Taoiseach accept that the Government did not adequately prepare for the current crisis and that this is why there were record numbers on trolleys, which caused enormous distress to people throughout the country? Will he confirm that real, meaningful funding will be provided to underpin the recommendations of the bed capacity review in terms of extra beds in 2018?

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