Alan Kelly (Tipperary, Labour) | Oireachtas source

I thank Fianna Fáil for moving this motion, although I will be forgiven for feeling like this is Groundhog Day all over again. We go around and around debating this. Unfortunately, I do not believe that we, as a collective political institution, are taking one another seriously enough. There is a lot of politics, but I am not sure that there are many solutions.

Talking about the situation with trolleys and emergency theatres is like talking about the weather now. It is that neutralised and socialised, which is awful. The county I come from has the worst issues proportionately with admissions to hospitals. We have Limerick on one side and south Tipperary on the other. Although they get beaten the odd time, those two hospitals usually have the most number of people trying to get into them. For us in Tipperary, it really is like talking about the weather. This is not an issue of staff or management, whom I support in both locations. They dread going into their respective hospitals. Imagine being a public representative whose constituents dread going into their local hospital. That is what my fellow Tipperary Deputies and I live with every day.

Just like others, a number of members of my family were on trolleys in University Hospital Limerick, UHL, in recent weeks. The circumstances people are being left in are disgraceful. The discourse that emanates from that goes against all of the good work being done in health, for example, cancer strategies, maternity strategies and other public health strategies. We must fix this. Surely it cannot be beyond the capacity of the body politic to do so. I say with great sincerity that the Minister is going to wish that the election was this month. Unfortunately for the general public, if we have a flu epidemic, or even if we do not, it will be hell. It is already hell where I live, so it will be an even worse form of hell. The situation is that bad. I do not say this with any political glee.

We know about the more than 100,000 people on trolleys this year and the record levels of overcrowding. What gets to me is the volume of elderly people who are being left on trolleys. I am not unique - other mid-west representatives are present. The amount of times one must fight to have elderly people, who are obviously more vulnerable than others, prioritised is ridiculous. Since starting in politics, the proportion of my time spent fighting for patients to get access to hospital services has multiplied on a scale that I cannot even estimate. I did it today. I have been fighting for people all this week, all last week, all last month, every week and every day. That is not the role of a Deputy, but because of how the system is failing, we are left in a scenario where probably all Deputies must try to intercept and fight those parts of the system that are falling down.

I will tell the Minister a story - I have the lady's permission; her name is Deborah - as an illustration of how bad things are. Deborah needed an operation on her gall bladder, which is not the most significant of operations but is quite painful. She was admitted to UHL. The people there first believed that they could take her as an outpatient, but she was then brought in. The consultant switched views on this after a number of weeks and realised that the operation could not be done in UHL and she would have to be transferred to St. Vincent's. St. Vincent's could not take her, though. I had to intercept the issue, call St. Vincent's and ask why the consultant was not doing more procedures. Obviously, he has private and public practices. He is going under the tunnel on a Tuesday to work Wednesday, Thursday and Friday, and on Monday and Tuesday he is working in the public practice. More than anyone, I am with the Minister as regards private practice in public hospitals.

I, a politician, had to fight to get Deborah transferred to St. Vincent's. Just before she actually got there, she got a letter from its outpatient department telling her the date for an outpatient appointment for a bloody operation that she did not even have arranged yet. I had to tell the CEO's office in St. Vincent's that this was happening. The hospital had given an outpatient appointment to a lady who was in UHL awaiting transfer to St. Vincent's for an operation that the latter could not provide because she had not even been transferred yet and the consultant could not take her. After the appointment at St. Vincent's was cancelled a number of times, she eventually had the procedure. This came 11 weeks after being admitted to UHL to have her gall bladder removed. For 77 days at a conservative figure of €1,300 per day, that is more than €100,000, not counting additional costs like medicine. By the way, she was given the wrong medicine twice. Spending €100,000 to have a lady's gall bladder removed is the situation that this country is in. It is crazy. Is it any wonder that we talk about the amount of money we are investing in healthcare when it costs €100,000 for a lady to get her gall bladder removed?

I have asked the director general of the HSE, Mr. Paul Reid, to look into this matter, which is a scandal.

What the Minister said about the embargo is rubbish. There are many examples of recruitment not happening. I know of a person who was offered a role but who is now emigrating because the appointment has not been made.

I will not talk about the HSE's winter plan because it is effectively a case of putting a finger in a dyke. The overcrowding situation is so bad in some hospitals that one clinical lead told me in recent weeks that it will lead to a catastrophic event, if not multiple such events, in the coming winter period. This very experienced person is effectively saying, and it is not said lightly, that people will die unnecessarily. The Minister has challenged everybody here to provide solutions. I wrote to Mr. Reid about the issues at UHL and requested answers regarding how it is proposed to deal with the situation there in both the short term and the medium term. I was not happy with the response. I have undertaken a comparative analysis of UHL versus Beaumont Hospital, which are two similarly sized hospitals with similar catchment areas. It is bad enough that UHL is €40 million in deficit in its current funding but when it comes to nurse numbers, there are 1,016 in that hospital compared with 1,294 in Beaumont. That is a substantial difference, especially when one considers that Beaumont does not treat as many patients. I can share all these data with the Minister.

We must deal with the issue of consultants, as the Minister is well aware, and that requires tackling the embargo. Bed provision is another issue. The Minister visited Our Lady's hospital in Cashel three years ago but the unit there is still lying idle. That represents an absolute waste of resources. There are issues with model 4 hospitals and problems with care pathways. Nenagh and Ennis hospitals, both in the mid-west, should be used more. Their minor injuries units, for example, could be utilised to widen the pathways. There are issues to deal with in regard to intermediate vehicles and making sure patients are transferred more quickly. Another issue is that I do not know why we are not giving the flu vaccine to more people for free. There would be a saving for taxpayers in doing so because fewer people would end up in the acute system. The Minister is well aware of the issues concerning home care packages.

Solutions are being put forward. I urge the Minister, as we move into late November, to examine the four or five really bad hospital situations and work with the director general of the HSE to put in place plans that are specific to those hospitals and which give far more detail than is in the winter plan. Otherwise, what I described at the beginning of my contribution will, unfortunately, come to pass.

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