Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

A 15 year old girl with scoliosis has had her operation cancelled repeatedly. As she has waited, her spine has curved to almost 90°. A mother in Wicklow has waited years for speech and language therapy for her son. Three weeks ago, she got a letter saying it will be another two years before he is seen. Men and women who are well enough to be at work are instead lying in hospital beds because this is the only way in which they can access diagnostic services such as MRI scans. They are told that if they go home they could have to wait six months, 12 months or two years. A young man paralysed in a tragic accident waits month after month for a bed in the National Rehabilitation Hospital. A college student at risk of self-harm and psychotic episodes waits in a Dublin emergency department because she cannot get any mental health support in her college. A 70 year old woman waits on a trolley in an emergency department in Limerick for four and a half days.

There is a very brave man called John Wall who is an advocate for medical cards to be granted to people with terminal illnesses. He tweeted the following yesterday: "My public oncologist cancelled my MRI scan last week because after waiting 3 months, I'd no option but to get it done privately." Mr. Wall has stage 4 prostate cancer. He also had his medical card cancelled twice by the HSE, which repeatedly asked him whether he still had a terminal diagnosis.

The public healthcare system is broken. In the words of Tony O'Brien, it has suffered from nine years of governance vandalism. More than 1 million men, women and children are now waiting for some form of healthcare. Children with special needs are waiting three and a half years to see a therapist. Mental health services are now so far beyond breaking point that, in many parts of the country, they no longer exist. So far this year, before we come into the winter, more than 10,000 women and men over the age of 75 will have waited in emergency departments in a chair or trolley for more than 24 hours. For the first time ever, people are ringing GPs and being told that they will have to wait one, two, or three weeks before they can be seen. Every month, 7,000 men, women and children are being added to a healthcare waiting system. This is equivalent to all the men, women and children of a medium-sized town every single month.

This is not normal. Some people ask whether this is not just how healthcare is. It is not how healthcare is. It has never been how healthcare is in Ireland and it is not how healthcare is in any other developed country on earth. In 2015, the Taoiseach, Deputy Varadkar, was the Minister for Health. He made a promise that his Government would bring to zero the number of people waiting more than a year and a half to see a doctor. When the current Minister for Health, Deputy Harris, took over in 2016, the number of men, women and children waiting more than a year and a half was 13,000; today it is 106,000. That means that for every man, woman and child who was waiting for more than a year and a half when the Minister was appointed, there are now seven waiting. The quality of healthcare in Ireland is, by and large, excellent, but quality is of no use if healthcare cannot be accessed. Quality can only be maintained for so long.

Healthcare professionals told the Oireachtas Joint Committee on Health last week that the national programmes are at risk: the national cancer care programme, the national maternity strategy, the national critical care programme, the national mental health plan - the list goes on. This budget should have focused ruthlessly on access. The parts that Fianna Fáil secured did exactly that. Additional funding for the National Treatment Purchase Fund, NTPF, will mean many thousands of men, women and children will be treated next year who otherwise would not have been. One million extra home help hours mean that men and women can be discharged from hospitals to their homes where they need to be, freeing up beds.

Ultimately, however, this is the Government's budget and years of mismanagement have taken their toll. We have the lowest level of hospital consultants anywhere in the developed world. Last week, we heard that last year almost 1,500 doctors deregistered from practising medicine. Just three years ago 500 deregistered. In a few short years the number of doctors deregistering has increased threefold. For every one who left three are now leaving. Hundreds of consultant posts remain unfilled. The agreed safe staffing levels for nurses and midwives have not been reached. Ending new entrant pay inequality for consultants should have been included in this budget. The full year cost is approximately €20 million. Last year, the increase in agency costs was €60 million. Reaching safe staffing levels for nurses and midwives should have been included in this budget. The Taoiseach promised that all graduating nurses and midwives would have jobs in their own country. The de facto embargo means they do not. They are leaving and many of them have little inclination to return.

The Government claims that budget 2020 includes an additional 1,000 healthcare professionals. In the small print however, in the web-based version of the document we got, it states 1,000 healthcare professionals would cost €60 million, we are putting in €10 million but we will put in more in the future. In other words, budget 2020 does not provide for 1,000 healthcare professionals. It provides for approximately 160 extra healthcare professionals. Funding to progress the national maternity hospital and the maternity hospitals should have been included. All three Dublin maternity hospitals should be moving, but in spite of years of promises, nothing is happening.

Budget 2020 contains a huge increase in healthcare spending for the fourth year in a row. Over the past four years healthcare spending will have increased by an astounding €4.9 billion. Somehow at the same time patients are waiting longer, suffering and deteriorating. How is that possible? It is partly down to the overspends. People say overspends are just part of healthcare. Here is the trend for HSE overspends. From 2005 to 2010, inclusive, there was no overspend. In 2016, the overspend was €500 million; in 2017, €200 million; in 2018, €650 million and in 2019, €350 million. The Government's response to this year's overspend is to say the HSE did a good job because it is less than the overspend of last year. It is not less than the overspend of last year because the €650 million overspend of last year is included in this year's budget with no additional targets attached to it. It is like asking someone to go to the shops and buy €50 worth of groceries. They come back and say they got the €50 worth but it cost them €60 and they do not know where the extra €10 has gone. The following week they are sent again and come back saying the €50 worth cost €65 but that is good news because last week they overspent by €10 but this week that has gone up by only €5.

Ireland's public healthcare system is in freefall. Access is collapsing under the weight of what has happened over the past nine years. Men, women and children are waiting and suffering and getting sicker, and this has to change. To do this we have to have enough healthcare professionals. That means ending pay inequality, lifting the de facto embargos and improving working conditions. We need to get spending under control so that extra money means better services. That means multi-annual funding, which does not exist, so that healthcare managers can plan more than a few months in advance. It means collecting basic financial data, which are not collected. As an example, the HSE does not know per hospital how much it is spending per bed night. That is extraordinary. We must get better at using the facilities and assets we have. The diagnostic suites, for example, should be open longer. Healthcare workers and their teams should be rewarded for doing things better. Their successes should be spread throughout the country.

We have to invest in the future. That means new technology for healthcare professionals and patients. Electronic records are essential. That means building the maternity hospitals and getting the national maternity strategy moving again. It means new beds so badly needed in Limerick, Galway, Cork and Waterford, and opening closed beds that are sitting there in Letterkenny and other places. It means teams of GPs, nurses, therapists and mental health professionals working in our communities helping patients manage their health, not telling them they cannot be seen because there are no diagnostics, GP, mental health service or therapists and that when they get really sick they can go into an emergency department and wait like everybody else. We are better than this. We have been better than this. Every other country in Europe is better than this. Budget 2020 gives another €1 billion to the health service. If it is used well and if the other €17 billion is used well, Ireland could have a great public healthcare system. That is what we must all demand on behalf of the men, women and children of this country.

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