Alan Kelly (Tipperary, Labour) | Oireachtas source

I have a sense of it being Groundhog Day again. We have been here many times. One of my daughter's favourite artists is Pixie Lott who has a song called "Here We Go Again". We could recycle much of the debate from the previous three or four discussions we had on this issue. I will not bother the Minister of State, Deputy Jim Daly, with any political point-scoring, but I will make a few points that might be helpful. We are aware of the issues concerning emergency departments and waiting lists. We know the consequences in terms of the number of people who die as a result of waiting lists and the current crisis. That is not a reflection on health service staff and I dare say it is not a reflection on management. One significant issue is that we do not have enough consultants or specialists. Hiring consultants who are not even on the register poses a serious risk. Hospitals are acting at a capacity that would be considered a national crisis or emergency in most other jurisdictions. In Britain and other jurisdictions hospitals stopped taking on new cases and cancelled elective surgery because of the situation with emergency theatres in particular. We could also create greater efficiencies.

I will make one or two points which I believe will improve matters. We have a number of different tiered hospitals. In fairness to the Minister of State, Deputy Jim Daly, he was in the grounds of Nenagh hospital not so long ago where he saw the extensive space available and the major advances that are taking place. Let us take the mid-west as an example and, if necessary, the south west and Bantry hospital. In the cases of Ennis hospital, St. John's Hospital and Nenagh hospital, the pathways for managing how people are treated in hospital networks must change. The minor injuries units are too restricted in terms of what types of patients they can take. They should be able to take fracture patients and deal with a number of other issues. That would mean University Hospital Limerick would not be clogged up. I have been making that argument for some time.

The grade 2 hospitals should be open for longer and be able to deal with a wider range of ailments. They should also be able to provide step-down facilities and take patients preparing for surgery and following surgery. They should be able to do so more quickly to free up beds in the acute hospitals, in this case University Hospital Limerick and in the case of the Minister of State, University College Cork. The cost of such an initiative would be small and it would save money because people would no longer block beds. In many cases, people cannot be transported from Limerick to Nenagh. We have transport known as intermediate care vehicles but there are not enough of them, they only run from Monday to Friday and sometimes they are not available. Ambulances transport people from an acute setting to the grade 2 hospital where they are treated in a fantastic setting but we cannot move enough people out quickly. The same story is replicated across all the networks. I urge the Minister of State to take that on board. I sound like a broken record speaking about this issue.

We also need to create greater capacity in hospitals. It is proposed to build a new 96-bed unit in University Hospital Limerick. Given that it will take years to build the new unit, we will have to consider taking a modular approach. A proposal has been put together which would cost the HSE €19.45 million in capital expenditure following the bed capacity review.

In the south of my county, in Clonmel hospital, the situation is chronic and to the north, in Limerick, the situation is woeful. The two worst emergency departments in Ireland in terms of overcrowding and trolleys are on either side of me. There are plans for a modular unit in Clonmel hospital and I am told this will be built and ready for the coming winter. I hope it will be ready but I have my doubts. The biggest issue in the country is in Limerick. We will have to support the CEO of the University Limerick hospital group in the application the group has made for funding.

I have a concern about Sláintecare not being implemented. A head of Sláintecare has not been appointed despite the post being advertised for a long time. I understand a number of other positions are being advertised within the HSE. If these positions are filled, I wonder how the roles we have planned in Sláintecare can be upfilled. I urge the Minister of State to examine the issue.

I will not repeat what is already on the record about the necessity for primary care but the current model, under which bundles of primary care buildings are being developed across the country, is not working in some cases. It has led to speculation. Speculators are getting a licence to build a primary care centre, sitting on it for a period and then trying to sell it on at a profit. This practice should not be tolerated. A deadline should be set within which a developer must meet all requirements in terms of providing general practice and other facilities. The project should be taken off any developer who fails to meet the requirements and re-advertised because speculation is taking place all over the country, including in my county.

Issues affecting waiting lists span a range of areas. I wish to raise two cases which I have been given permission to bring up. One is a case I raised previously with the Minister of State involving a young man who is not even from my constituency - he is from Waterford. We will call him by the initials ND. He has various issues affecting him and his family has been looking for residential care for a long time. I will not name him or his family but I have permission to do so if the need arises. I have written to the Minister of State to explain that some families are being put in dangerous situations due to the lack of residential care. This will become the next scandal if physical violence or issues relating to sexual activity arise. I have dealt with a number of such cases. In fairness to the HSE, it has dealt with many of the cases I have raised with it, but this is one of the more worrying cases. I urge the Minister of State to examine it.

I also raise the case of Matthew Quinn, which is a little closer to home. Matthew lives about a quarter of a mile away from me, just over the hill. He was delighted to feature on RTÉ last week. He is a 14 year old with Down's syndrome who has been waiting for a hip replacement for two years. He asked Santa Claus to bring him a new hip and when I visited him he asked me to help him to get a new hip. He does not want anything else except a new hip because he is totally immobile and in pain. He featured on "Six One" news last week. We fight for various issues but this young boy, who is a big lad, deserves to have his surgery. Issues have arisen between the paediatrics services in Crumlin and Tallaght hospitals. I have been raising these for months and I do not understand what is going on. I have spoken to the surgeon and there is no reason this issue cannot be dealt with. It is symbolic of a bigger issue between the hospitals. I urge the Minister of State to investigate this case because this young man, and others like him, do not deserve to be left in this position.

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