Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I commend Deputy Louise O'Reilly for tabling the motion which Fianna Fáil will support.

Imagine spending every day in intense and debilitating pain knowing that there is a standard operation available but that, because one lives in Ireland and does not have private health insurance, one has to wait two and a half years for it. That is the story of Sarah from Wicklow who is waiting for a hip replacement operation. Imagine having a daughter with scoliosis and seeing her spine curve more and more to the point where she will no longer fit in her wheelchair and knowing that because she lives in Ireland and her parent does not have private health insurance she must wait for more than a year for an assessment to receive a new wheelchair. That is the reality for a mum and her daughter in Bray. Imagine being a manual labourer with shoulder pain that has got so bad that they cannot work who faces the prospect of losing their home because they live in Ireland, do not have health insurance and have waited a long time, not even to be treated but only to be assessed. Imagine being the patient of a GP who contacted me this week, having just been told that she would have to wait for 160 weeks to see an ear, nose and throat specialist. That is the reality on the ground. Some 55,000 children are waiting to see specialists, never mind receive treatment. For the first time in the history of the State, more than 10,000 children are waiting for longer than a year and a half to see specialists. There are not many of us living in the Republic, but more than 500,000 are waiting to see specialists and more than 700,000 are waiting for procedures, the highest number in the history of the Republic.

This morning I met two mothers whose sons had scoliosis. It was difficult to listen to what they and their sons were going through. If a GP believes a child might have scoliosis, that child will be referred to a specialist in a children's hospital. In the case of Crumlin, the child will have to wait between two and three years to be seen by the specialist. That is where we are with waiting lists for children with scoliosis. In January 2017 the target for the length of time taken from finally being seen by a specialist to undergoing a procedure was set at four months. The women whom I met and the parents of other children with scoliosis were told that an action plan would be published by the end of last year. Needless to say, it has not been published and the four-month target has not been met.

The latest Euro Health Consumer Index, EHCI, shows that, of the 35 European countries surveyed, Ireland came last in ease of access to healthcare. It noted that in 2015 Ireland had set a target of no patient having to wait for longer than 18 months for a specialist appointment. The authors put a large exclamation point in one part of their report. It read: "Even if and when that target is reached, it will still be the worst waiting time situation in Europe". To be clear, Fine Gael's target for waiting lists which it cannot even hit would still leave us with the worst waiting times in Europe.

It is not down to a lack of funding. Ireland spends more money per person on healthcare than almost any country on Earth. Since Ireland has a significantly younger population than most other countries, we should be getting better healthcare for the same amount of money that other countries are spending. Instead, we are spending more and receiving worse healthcare. Neither are the problems due to a lack of talent or passion on the part of clinicians. We have some of the best trained doctors and nurses in the world who, as we all know, are dedicated to the cause and want to do the best job possible. It is down to a lack of ambition, vision and competence.

In 2011 Fine Gael announced that the HSE would be disbanded. In 2012 the Government fired the HSE board in front of the cameras. In 2014 the HSE was again told by the Government that it would be disbanded. This time ot was told that it would happen by 2020. In 2016 it was told by the Government that it would no longer be disbanded. In 2017 it was told that it would be reorganised according to Sláintecare. In 2018 it was told that it would be getting its board back. There is not a management team on Earth that could deliver for the people a great healthcare system, given this level of organisational chaos. In that chaos waiting lists have spiralled and men, women and children are suffering everyday.

What did the Government try to do to tackle waiting lists? It moved the target from six months to nine. As it did not achieve it, it moved the target to 15 months. As it did not achieve it, it moved the target to 18 months, which is where we are now. Will it, please, not do that? Will it provide clinicians and managers with the tools they need and identify where things are working? In some places they are working. In the RCSI hospital group many waiting lists are decreasing. We should find out why and share the learning across the system. The Government should help hospitals to reduce admissions from their emergency department. In some hospitals the relevant figures are in the teens, but in others, they are in the high 20s. Why is that the case? The Government should help hospitals to find appropriate step-down care when they discharge patients in order that they will not end up back in emergency departments a few weeks later. The Government should help hospitals to tackle bottlenecks owing to bed shortages, be it in ICUs, wards or elsewhere. The Government should deploy technology and education to help patients to manage their own care. The Government should held GPs to provide as much care as possible in their surgeries in order that they will not need to keep referring patients to local hospitals. The Government should ensure spare capacity in hospitals is being used. In many cases, it is not. The Government should balance the load between hospitals throughout the country in order to reduce the worst waiting lists. The Government should provide higher volume, simpler care in smaller hospitals, provide complex care in larger hospitals and ensure doctors get to work in both settings. The Government should use the NTPF as a temporary measure to provide men, women and children the care they so desperately need.

If the Government sets targets that will give us the worst waiting times in Europe, we will have the worst waiting times in Europe; therefore, it should do not do that. It should set targets that are humane and ambitious and reflect the level of service we want and that the people deserve. It should work closely with doctors, nurses and hospital managers to turn the targets into the reality they must become.

See this speech in context