Mattie McGrath (Tipperary, Independent) | Oireachtas source

The IMO went on to say the reality is that spending on public health services has not kept pace with either rising demands or the increase in the number of patients over 65 years. That is a staggering statement by the IMO.

The same is true two years later in 2019. Everyone knows the primary care budget will not keep pace with the health demands and the various crises affecting the health services. The new CEO seems to have been brought in because he is a whizz kid at keeping within budget. That seems to be his main credentials for the job, and his career to date, although I accept he has other qualities also. This will not be good. It will not be fair. It is not decent. I accept that it is primarily a management issue but it is something we need to tackle once and for all. We must work to change this or else GP services will continue to be even more overwhelmed and will only be able to deliver the most acute of services due to the lack of resources and unsustainable costs.

An additional problem has also emerged due to the lack of focus on primary care delivery, namely, that doctors have continued to emigrate in droves rather than work in a service which is increasingly not fit for purpose. I know a doctor, Paddy Davern, from Tipperary Town. He is an exceptional doctor who is known far and wide and he went to Dubai two years ago. He told a public meeting in Horse and Jockey that he had to leave and he reduced people to tears. He is sorely missed in Tipperary Town and surrounding areas. That is happening in every county. When will the Minister deal with it? There is a serious lack of ambition.

Two years ago the Minister spoke about the much heralded transformation of the delivery of the health service and the move to GP-led primary care. Dhá bhliain ó shin. Has that happened? No, it has not. Does the Minister ever replay the clips of speeches? I do not blame him personally for everything but he is the man in charge. Does he ever look back and say he spoke those words with good intent, honesty and passion but it has not happened? The failures are heaped on failures that are heaped on failures, not only by the Minister but by successive Ministers and Governments. That is so disappointing given that primary care is one of the measures that has been shown to be successful in addressing the problems of chronic overcrowding and long delays in accident and emergency departments. That is shown to be the case in particular where ultrasound diagnostics have been introduced in local primary care centres. I am aware that it was implemented in CHO 5, where GPs could directly refer adult medical card and GP visit card holders for X-ray and ultrasound to a number of identified providers. That was supposedly a short-term emergency measure designed to relieve pressure on hospitals in the immediate post-Christmas period. We need such measures to be rolled out on a more consistent and long-term basis. The Mary Street Medical Centre in Clonmel is an excellent example of a primary care centre that has been attempting to implement the use of ultrasound in diagnostics in order to help patients receive quicker treatment. The Minister visited the centre.

In February 2017 it was awarded a contract by the HSE to carry out such diagnostics. Astonishingly, the contract was only for the duration of 14 days and was subsequently withdrawn after just seven days. That was after all the effort, work and high level meetings, in addition to the associated cost and the passionate and desperate efforts of the Mary Street Medical Centre to provide the service. It had the equipment and expertise but the contract was ended. That is incomprehensible. That is despite the fact that it carried out 35 scans in seven days, making earlier diagnosis possible, thereby benefitting patients and preventing referrals to a chronically overcrowded accident and emergency department in South Tipperary General Hospital. Patients and doctors alike praised the service yet the HSE refused to extend the contract. What is wrong? How can there be such a blockage and chronic administration issue that a tried and tested service was halted seven days after its introduction?

One patient who was helped by the ultrasound service was a lady who was diagnosed with a tumour in her womb. Thankfully, she has since had surgery to treat it. She might no longer be with us if the tumour was not diagnosed. That is simply bizarre and unbelievable. If she had experienced a 12-month delay waiting for an ultrasound in the public system her outcome would undoubtedly be far worse. She is a GMS patient and would otherwise have had to pay for her scan. The case clearly demonstrates the benefits primary care can deliver, not just for patients and their families but also for the entire health service where the bottleneck situation in accident and emergency departments can be reduced.

I appeal to the Minister, who is probably in the dying months if not weeks of the Government, to please make his mark and provide services in the Mary Street Medical Centre in Clonmel in Tipperary, which has the capacity, willingness and foresight to deliver a service which benefits everyone, gets rid of the queues and saves people's lives. Could he please cut out the dead wood in the HSE and allow this badly-needed service to continue and to deliver for sick patients who are waiting with anxiety.

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