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

The health service is in a perpetual state of crisis. The Minister of State at the Department of Health, Deputy Jim Daly, knows that; I know it; we all know it. We see it every day in our advice clinics and read about it every day in the newspapers. It started a long time before the Government had the really convenient excuse of Brexit which it blames for everything that goes wrong. We have had eight years of Fine Gael in government, four budgets with its best friends in Fianna Fáil and what has it brought us to? People cannot afford to see a GP. They go without; they wait until they are really sick with multiple ailments and if they have the money, they spend the €60 to see a GP.

In the area of primary care the Government increased the threshold to qualify for a medical card for those aged 70 years and over, something which will benefit many. As a move towards a universal primary care system, I welcome it, but what about those who are younger than 70 years? What about the young workers living alone who earn a little over €184 a week after tax? There will be no medical card for them and none for the couple with a child who earn over €266.50 after tax. Sinn Féin proposed that the roll-out of universal free GP care be advanced next year by giving everyone without a medical card or a GP visit card two GP visits without charge per year in order to lift the burden of being sick off workers' families and young people. Many of them cannot afford to be sick. The measure we proposed would have benefited 2.8 million people, including the retail worker, the mechanic, the butcher, the prison officer, the student, the teacher, the tradesperson and many more. The Government announced nothing for them to make their lives easier or give them a break.

The home support waiting list of people who need just a few hours help in order to stay in their own home stands at 7,000, almost 1,000 of whom are in north Dublin. I know this because many of them come to me looking for help. They are not looking for much, a couple of extra hours. That is all they need to help them to stay safely in their own home. The service has been targeted for cuts, with the freezing of hours in the past six months. We have heard countless stories of children who have had to cut their working hours or give up their jobs in order to provide care for parents at home. The same applies to the parents of children with disabilities. They have had to take up full-time caring duties because of the lack of home support services. The Government could have tackled this issue in the budget, if it was fair, by taking part of the burden off those caring for loved ones, but it did not do so.

The Government heralded the allocation of an extra 1 million home help hours as a key measure in the budget. However, this addition will barely clear 40% of the home support waiting lists. The Minister of State, Deputy Jim Daly, confirmed as much to me today at the Minister for Health's press conference. The extra 1 million hours will leave people on waiting lists as an extra 1.5 million hours of home help are needed approximately. What are the people concerned supposed to do? A targeted allocation of €59 million was needed to get rid of the waiting lists. That is what the Department of Health and the HSE told us, which is why Sinn Féin included it in its alternative budget. It was a matter of choice.

The Government had the option to choose to do the right thing, namely, to invest in areas and people that need it, but it did not do that. Almost 700,000 people are on hospital waiting lists throughout the State but what is the Government's response? It is an additional €25 million for the National Treatment Purchase Fund, NTPF, a scheme that those working in the health service say does not represent value for money. They go as far as to say it is a cynical exercise in waiting list manipulation that does not ultimately improve care for people in the medium or long term. The Government chose to allocate scarce resources to the private health sector at the expense of increasing resources for the public hospitals. I tire of saying this given that when Fianna Fáil was in government, the geniuses working with it in the Department of Health came up with the idea of the NTPF and it was as wrong then as it is today. It did not work then and it is not working now. Every year, the Government invests more money in the NTPF but the outworking of that is seen in respect of waiting lists, which are not decreasing. It does not reduce the numbers and just removes money from the public health service. Outpatient waiting lists grew last year by 54,000 to 569,498, while the number of patients waiting more than 18 months has grown by 24,000 to 106,786.

The national maternity strategy needs at least €7.5 million per year over the next ten years just to keep it on track. I will not be distracted by a task force. We need implementation. A strategy exists and the Government simply needs to get behind it. In the budget, a sum of €8 million will be allocated among four essential health strategies, namely, the cancer strategy, the maternity strategy, the trauma strategy and Vision 2020, the ambulance reform plan. There are no measures in the budget to reopen closed beds to address the crisis in capacity, no idea of how the four strategies are expected to deliver on the budget allocated to them, nor a breakdown of how much money will go to each strategy. It is no wonder the Irish Hospital Consultants Association voted no confidence in the Minister for Health. The Irish Medical Organisation stated the budget will not allow for any new service development, while existing services will be further stretched.

The Government could have given a medical card to every patient who has cancer for the duration of his or her treatment or for however long he or she has cancer, which would have cost €40 million, or 0.0002% of the overall health budget. It could have invested in problem gambling supports to help with the epidemic of gambling problems that people experience throughout the State. It could have invested in helping women by rapid-funding the national maternity strategy, or tackling period poverty with money and resources, or rolling out a State-sponsored contraception scheme to provide for free contraception for all women. It could have invested in hiring the additional staff needed to reopen the 500 beds that were closed by Fianna Fáil. There is nothing in the budget for the children in my constituency who wait 33 months for what the Government call early intervention. If it had any shame, it would change that name. It cannot be called early intervention if a child must wait 33 months.

The budget, like all budgets, is about choices, priorities and ideology. The Government has nailed its colours firmly to the mast and delivered a budget for landlords, private healthcare providers, speculators and bankers. Sinn Féin would have made different choices that would have helped workers, families and young people, who are the people beside whom we always stand and for whom we are proud to stand up.

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