Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

This is also the third budget for which I have been in the Dáil Chamber. I have a new washing machine at home and it does not spin as much as this Government and its Fianna Fáil partners do in terms of this budget. When I look at the health section of the budget, behind the spin, the backslapping and the high-fiving that is going on, we see that the health service is now dependent on unreliable corporation tax receipts for funding. Not only are the additional measures announced absolutely devoid of any imagination, but the health section of budget 2019 has few or no costings for the few measures it does contain. It does not even provide a total at the end of the measures table. It is complete fantasy stuff. After hearing what was announced yesterday, I am even more concerned with the future of the health service than I was before this budget, and I was not exactly hopeful that this budget would do much. I set the bar very low, but the Government has managed to disappoint even me. It is using revenue derived from unexpected and unreliable corporation tax receipts to release funding to pay off the overspend and to bolster current spending for 2019.

For years the Fine Gael Party has come in on budget day and cut the health budget or left it underfunded. It then flaunts spending on necessary services the health service needs to merely stand still, and it has the nerve to call this investment. To be clear, this Government may spend money on health, but it does not invest in it. This budget offered the opportunity to set out a sustainable and credible funding path for the health service in order that it could address capacity issues, the recruitment and retention crisis and funding shortages and to deliver a sustainable delivery plan for Sláintecare. Instead, Fine Gael, with the support of Fianna Fáil used unexpected and unreliable corporation tax receipts for a quick short-term fix for the health budget. This is not just deceptive, but is extremely dangerous.

The budget has done nothing to address some of the biggest crises facing the health service, including the crisis of capacity and the recruitment and retention crisis among nurses, doctors and health workers. It has done little or nothing to address the serious capacity deficits delaying the provision of public hospital care and primary care to our patients. It has done nothing to address the reasons behind the recruitment and retention crisis among nurses, doctors and GPs. The Minister does not have to listen to me. He can hear the same thing from the Irish Nurses and Midwives Organisation, INMO, the Irish Medical Organisation, IMO, and the National Association of General Practitioners, NAGP. He can listen to Deputy Harty. These organisations are all saying the same thing. No measures to improve capacity and no measures seeking to address the recruitment and retention issue were included in the budget.

The budget sends a very clear message to healthcare workers who have left our health system and are working abroad. It tells them very clearly that we do not want them and that they should not come back because we are not going to fix the issues. It says that we are happy to outsource and privatise health, and to continue doing what we have been doing. So little has been offered to Sláintecare that it will not be able to deliver badly-needed reforms. Instead of investing in the public health system the Government has announced more money for the National Treatment Purchase Fund, NTPF, to siphon public money off to private healthcare in order to line the pockets of private healthcare providers. I have said this many times before, but it is worth repeating that investing in the private sector has not and will not ever improve the public health service. It lines the pockets of private health providers. The Minister should not take my word for it. Dr. Sara Burke of the centre for health policy and management in Trinity College Dublin has said that over a decade of pouring hundreds of millions of euro into the NTPF is proof that it does not address the underlying causes of the long waits for public patients in the first place. Some Deputies have claimed that lives will be saved by the NTPF.

I have an ideological opposition to private healthcare. Everybody knows that. However, if I believed that the NTPF would make a real and substantial difference to healthcare delivery in this State, I would back it 100%; I do not. All the expert evidence suggests that it will not work to address the underlying reasons why we keep referring to our health service as being in a state of crisis. We have been given uncosted and non-credible claims and statements. The section of budget 2019 that deals with the health service points to some new measures the Government claims it will deliver, but none of these is costed in any detail. In previous years, the summary of new measures to be delivered contained a detailed breakdown of the funding to be provided for each additional measure. That is absent from this budget. We also want to see if money will be put aside to address issues that I have raised here concerning Epilam, transvaginal meshes and the myriad crises and scandals that have resulted. This back-of-an-envelope calculation does nothing for those women. When they look at the budget, they see there is nothing in it for them.

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