Michael Harty (Clare, Independent) | Oireachtas source

I raise the issue of a perfect storm facing the health services, into which the Government has sleepwalked over the past eight years. I refer to the recruitment and retention of consultants in the hospital system. This results from years of accumulated neglect in reforming models of care and developing the health services to maintain critical service delivery to patients. With a booming economy and almost full employment, we still have a dysfunctional health service, which affects many specialties. Fiscal prudence is as much about how we spend our money as how much money we spend and we need to get maximum value for the money we spend. Throwing money at a failed health system will not solve the problem. The Government's lack of curiosity in this regard is astounding. We are speaking not about additional funding but about spending money which has already been allocated.

I will highlight a number of issues. Vacant consultant posts are caused by pay disparity and intolerable working conditions. Employing locums and non-qualified consultants in a vain attempt to plug the gaps in consultant numbers is compromising the quality of care. There was an accepted maxim that there was a bottleneck when entering the system but that once one did so, one was guaranteed quality of care. That is no longer the case. Approximately 500 consultant posts are vacant: 54 in general medicine, 34 in anaesthesiology, 25 in emergency consultants, five in intensive care, 17 in obstetrics, 34 in paediatrics, 56 in pathology, 101 in psychiatry, 37 in radiology, 57 in general surgery, four in medical oncology and three in cardiology at least. This will not be news to the Taoiseach or the Minister for Health as it has been highlighted in many reports. The consequences are that more than 500,000 people are waiting for a first appointment to see a consultant, 150,000 of whom have waited for more than one year and 96,000 of whom have waited for more than 18 months. Some 10,000 children are waiting to see a consultant for the first time, before they ever go on an inpatient waiting list if they require ongoing treatment.

In addition, the Taoiseach showed a great lack of understanding of home help services last week, when he said that in spite of a 50% increase in the funding allocation to home help services, he saw no tangible benefit in the reduction of people attending hospital services. That is to misunderstand completely the purpose of home help. Provision of home help is the right thing to do. It is not about saving money or reducing attendances at hospitals.

When will the Taoiseach understand that the manner in which we spend money, rather than the amount we spend, is critical to the health service?

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