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

The revelations in yesterday's Irish Timesof the correspondence between the chief executive officer of the Health Service Executive and the Minister and the Department of Health demonstrate a very flawed and essentially opaque approach to the funding of our health services. At the very least, they show a very poor sticking plaster is being applied. There is a complete lack of transparency, substance and, most worryingly of all, credibility surrounding these figures. There is a bogus, spurious element to some of them and, indeed, a clear statement in the correspondence that they will not translate into reality. With all the talk of the implementation of Sláintecare, the crisis in accident and emergency services, overcrowding, and the bed capacity review, in essence these figures and the correspondence between the HSE and the Minister show that the health service will at the very best stand still if not face more cuts to vital services in 2018. Given that the pay agreements will absorb the bulk of the increased expenditure, there will be little for additional services. The elderly will continue to suffer, the disabled will still be shortchanged in respect of access to therapies and services, the acute hospitals will remain under intense pressure, notwithstanding the experiences of December and January, and primary and community care will remain neglected.

Specifically, according to the HSE's own internal assessment, there are "long waiting lists" in respect of gynaecology and "poor access to treatment [has] left thousands of women with a poor quality of life". Regarding anaesthesia, the HSE states that "Serious clinical risk exists because [there is only] one line of anaesthetic call" in most general hospitals and accident and emergency departments. The HSE states that there is "a national shortage of critical care beds" which is "impacting on access to scheduled and unscheduled care services". Ophthalmology theatre closures and waiting lists are "affecting preventable deterioration". Urgent targets will be missed in endoscopy and colonoscopy. There will be a staffing deficit in 2018 right across the spectrum of cancer care for child and adolescents and in geriatric oncology, radiation, surgical and medical services. The correspondence goes into other specifics, such as the need for 80 beds and five theatres in Our Lady of Lourdes Hospital, the dialysis unit in Galway and so on.

Most damning of all, the so-called value improvements or cost savings have not been identified and are extremely vague. The chief executive is stating large tranches of these savings will be very difficult to realise and, if we read the language, will not be realised.

Does the Taoiseach agree these Estimates lacked transparency in advance of the budget and have lacked it since and, in essence, they mask a deteriorating situation in the provision of services to our citizens in 2018?

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