Michael Collins (Cork South West, Independent) | Oireachtas source

I want to thank Máirín McGrath in Deputy Mattie McGrath's office and Deputy Michael Harty for their work on the motion. I stand to talk on health service reform but, in fact, I could be standing here a year from now and will we have a reformed health service?

The programme for Government promised the most fundamental reform of our health service in the history of the State. The need for change in the health service is unquestioned but where is this change? In November 2012 the Government approved Future Health - A Strategic Framework for Reform of the Health Service 2012-2015. Some of the measures it introduced were a health reform board, a programme management office in the Department and a system reform group in the HSE to drive the implementation of the health reform programme. It compiled two reports on the hospital groups, one on the establishment of hospital groups as a transition to an independent hospital trust and the other on securing the future of smaller hospitals. What actions have been taken on these reports? It is one thing to commission these reports but another to deliver action on them.

Healthy Ireland, under the heading Building Capacity for Self-care and Self-management of Chronic Diseases in the health service national implementation plan 2015-17, stated there would be implementation of a national framework for self-care for the major cardiovascular, respiratory diseases and diabetes. The HSE national service plan for 2018 states that its mission is to ensure people in Ireland are supported by the health and social care service to achieve their full potential.

It states that people in Ireland can access safe, compassionate and quality care when they need it and that people in Ireland can be confident that the HSE will deliver the best health outcomes and values by optimising its resources. This sounds like a wonderful plan but is there a realistic, achievable plan? Only last week I asked questions in the Dáil about the sad and shocking case of Vicky Phelan. When will there be justice for Vicky Phelan? Under the reformed health service, can the Government guarantee that this will never happen again to any person in the State? Why was there no accountability?

The current health system is unfair to patients and it often fails to meet people's needs. It is not fast enough but the long waiting lists and overcrowding are but some of the problems in the health service. Deputy Danny Healy-Rae and I will take two buses to Belfast again this month to facilitate people to have a cataract procedure. It only takes 15 minutes but people have been on waiting lists for up to four years in the Republic. Under the reformed health service, will we see waiting lists reduced, not just for cataracts but all procedures?

In December last year, my colleagues in the Rural Independent Group and I raised a motion on home care packages in which we called for the home care packages scheme to be established in law to allow everyone an automatic right to the service. Census 2016 recorded a 35% increase in the number of carers aged 85 and over. Carers provide over 6.5 billion hours of care per week in Ireland and, on average, they care for their loved ones for almost the equivalent of a full 40-hour working week. Almost 9% of them provide full, 24-hour unpaid care with no break at all. Last Friday, a constituent of mine from the Clonakilty-Timoleague area told me he cares for a loved one and gets carers allowance but he ends up being paid just €1.59 per hour for all he does. Many carers have to wait for over six months, which is an outrageous attack on our elderly and nothing short of abuse towards the person who cares for them. The first day it is proven by medical evidence that a loved one requires care, a social welfare payment should be made to the carer. This would cut out the shambolic carry-on of leaving a carer for five or six months without any payment, which is also outrageous.

The increased privatisation of community care is a clear indication that the public system is not working for some people. The fair deal scheme is the most unfair scheme that has existed in this health service, with people who have worked tirelessly all their lives being robbed of all they have saved by the system. Ireland has an ageing population and 30% of the population will be aged over 65 by 2030, which creates significant challenges and opportunities for Irish society, in particular the Irish health service which is in crisis and looks to be worsening. I cannot imagine how it might be in ten years if we do not begin to change it. In west Cork we have the largest population of elderly people in Ireland and we need extra beds for respite care and more supports for families which provide care for loved ones with dementia and Alzheimer's disease. We need to support and recognise the wonderful work the home help service provides, not only in west Cork but across the country. In most cases, only 30 minutes per day, five days per week is given by the home help service, which is utterly unfair. According to the Healthy Ireland survey 2015, 9% of the Irish population over the age of 15 have probable mental health problems.

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