Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank Deputy Harty and his colleagues for tabling tonight's motion on healthcare. Fianna Fáil is in agreement with much of tonight's motion, particularly the calls for immediate action for implementation for increased capacity in hospitals, in general practitioners' surgeries and in community care. I am pleased to say that Fianna Fáil will support this motion and has a very short amendment to the motion which we hope that Deputy Harty and his colleagues will support. It reads that the Government "in pursuing these healthcare goals, stay within the fiscal parameters required to maintain a prudent budgetary approach over the entire lifetime of implementation", which will be at least a decade.

Given Ireland's young population by international standards, we should not need to spend as much as other countries on healthcare. However, not only do we spend as much as other countries, we spend more per person than almost any country worldwide. Given that, and that we have really well trained doctors, nurses and other healthcare professionals, one would expect that we would have a Rolls Royce healthcare system but let us compare what we should have with what we have today.

We have the longest trolley lists in history. We have the longest waiting lists in history. There is a crisis across general practitioner practices that is so deep that seven in ten practices are no longer taking on new patients, whether private or public. We have a massive shortage of hospital beds, step-down beds, or rehab beds and a plethora of other different facilities. We have a chronic shortage of hospital consultants and people working as hospital consultants who are not even qualified as hospital consultants, and this has been the case for many years with the knowledge of the HSE. These are people working as specialists who are not on the specialist register. We do not have enough nurses and the job has become so difficult in recent years that over 70% of those who are about to graduate this year say they will leave the country, and not work in this system. We have non-consultant hospital doctors who tell me that their training hours are being falsified by their employers and that they are still working 36 hour shifts. Many of them are also leaving the country. I am told that we are the biggest importers and exporters of doctors in the developed world. That is a shocking indictment on our duty of care to our healthcare professionals.

Then there is our culture of secrecy. The Portiuncula report which came out last week would make one's blood run cold. There needs to be time given for this House to debate it. The cover-up which was uncovered in the Portiuncula report and what families whose babies died in that hospital is horrific. If it was not for CervicalCheck, the Portiuncula report would be on the front page of every paper, but we have another scandal that is so big that Portiuncula has barely been mentioned. The CervicalCheck scandal affects every woman and every family in this country. Every woman I have spoke to or who has contacted my office is furious. They are not a little annoyed, irritated or let down, they are furious that they could have been Vicky Phelan or that they could have been one of the 208 women where the HSE and State found out that their diagnosis had been missed but they were not going to tell them, rather just file it away, and that their doctors would be told that he or she did not need to tell the women affected either.

It is very clear that what has happened to Vicky Phelan is not an isolated case. It is only because of her bravery that we understand just how deep this conspiracy of silence has run. We now have correspondence that shows that the clinical director of CervicalCheck, who has now resigned, wrote to Vicky Phelan's doctor and said that they thought all the women in question should be told, but that they did not think they should do it themselves but rather the doctor should. They debated back and forth over whose responsibility it was and escalated it to the hospital group, but nobody made it public. Then they escalated it to the clinical director of the HSE who did not make it public and was assured that the matter had been sorted out. We have correspondence from the ex-clinical director of CervicalCheck saying that in her opinion, Dr. Hickey, Vicky Phelan's consultant, need only tell three of his ten patients. That is not an isolated event. It is a deliberate culture of non-disclosure.

The background to this is that in 2013 the HSE brought in an unambiguous open disclosure policy. In 2014 CervicalCheck decided it would do an audit. In 2015, two years after the policy of open disclosure, it decided it would tell the doctors. In 2016, three years after the policy of open disclosure, it actually got around to telling the doctors. In 2017, four years after the policy of open disclosure, Vicky Phelan actually found out about it. In 2018, five years after the policy of open disclosure was introduced, the other women affected and their families are now being told. This is a deep and sinister conspiracy of silence. The women of Ireland are furious and they are absolutely right to be.

I put it to the Minister that there is also a great deal of political accountability for this too.

The HSE board was disbanded by a previous Minister, Deputy James Reilly. It is now going to be re-established. That action clearly led to a lack of oversight and governance. Another Minister, Deputy Leo Varadkar, pulled away from legislating for open disclosure when there was an opportunity to do so. While I respect that the Minister, Deputy Harris, acted when he found out about the scale of this, I put it to him that there was sufficient information and there were warning signs in that memo to lead him to act sooner. I am sure the Minister would dearly love to have acted sooner and I believe he should have. It was clearly a political error to let Tony O'Brien take on a position on the board of a company on the west coast of America. I also put it to the Minister that it is an ongoing political error to allow the director general of the HSE to remain in situ.

The director general of the HSE needs to resign immediately, without prejudice, for three reasons. He was in charge throughout this entire thing, he is clearly a distraction from supporting the women involved, and the response to date in terms of the helpline has been shambolic. There are many other things that need to be done, but I put it to the Minister that as a first step and as a message to the women, and indeed men, of Ireland he should ask Mr. O'Brien to resign with immediate effect as the person who was in charge and who has, to date, essentially had ultimate governance for the helpline, which has been a shambles.

See this speech in context