Séamus Healy (Tipperary, Workers and Unemployed Action Group) | Oireachtas source

The health service is in chaos and crisis, whether it be the hundreds of thousands of people who are waiting to be seen as outpatients, those on inpatient waiting lists, the 100,000 people who have been on trolleys to date this year or the 300 elderly patients who will die unnecessarily this year on trolleys in our overcrowded hospitals. I raised this matter with the Taoiseach recently on Leaders' Questions and was shocked to hear him respond as if this situation was normal or acceptable. It is not normal or acceptable. In fact, it is the result of a deliberate policy pursued by successive Governments. It goes back quite some time, to the Hanly and Fitzgerald reports. Those reports were not accepted at the time. The policies underpinning those reports and their recommendations had been implemented on an ongoing basis by successive Governments. They took every opportunity to implement the recommendations, including during recessions. The saying is that one should never waste a good recession.

These policies were sold on the basis that big is best, centralisation is good and centres of excellence were needed. Big is not always best. Centralisation is not always good. All of our hospitals should be centres of excellence, and they can be if they are supported, funded and resourced properly. We need specialist hospitals to provide specialist services, but general medical services, such as general surgery, paediatrics, maternity care and accident and emergency departments can and should be provided locally to a standard of excellence. This is being done despite significant pressures on staff who work above and beyond the call of duty on an ongoing basis.

We can see the results of the policies pursued by this and previous Governments in our health service. There is absolute chaos, with severe overcrowding in hospitals and some 100,000 patients already obliged to wait on trolleys this year. At UHL, as many as 70 patients are often on trolleys, while nearly 50 patients are in a similar situation in South Tipperary General Hospital. That is the situation as it stands, and those are two of the worst hospitals in the country for overcrowding. However, every hospital is suffering as a result of that problem.

The overcrowding in our hospitals is inhumane. We have to remember that patients on trolleys are human beings and are entitled to service and respect. They are not getting that from the health service today. We know from professionals who have brought this matter to public attention, that this year and every year some 300 elderly patients will die in our hospitals unnecessarily, because of overcrowding, time spent on trolleys and the general chaos in the system. This situation has arisen due to the policies of successive Governments. My area includes Limerick and the mid-west, as well as what was formerly the South Eastern Health Board area and is now the South/South West hospital group area and these policies started to be implemented there way back in 1988. That was when the Government of the day closed 50 beds in St. Vincent's Day Hospital in Tipperary town. Taking those 50 beds out of the system immediately put great pressure on the other hospitals. That policy was continued when Our Lady's Hospital in Cashel was closed and another 30 beds were lost. That is a total of 80 beds having been taken out of the system in the south Tipperary already.

Turning to the mid-west, on the basis that big is best, that centralisation was needed and that an excellent service could not be provided in our local hospitals, which we can now see was incorrect, the Government of the day closed Nenagh Hospital, Ennis Hospital and St. John's Hospital in Limerick. We know and see the result of those closures daily in UHL. To give a concrete example, in South Tipperary General Hospital in 2011, when Fine Gael came to power first, some 700 patients were on trolleys. Some 6,000 patients on are now on trolleys in that hospital. It is a similar story in every other hospital.

South Tipperary General Hospital operates on the basis of 120% occupancy, while the medical department there operates on the basis of 150% occupancy. The generally accepted safe level of occupancy is 85% to 90% at most, so there is great pressure. We have to come to terms with the policies that various and successive Governments have been pursuing for years. We also have to face up to the fact that these policies were wrong, should not have been implemented and should now be reversed. The accident and emergency departments at Ennis and Nenagh should be reopened, because there is no doubt that the situation at UHL has been gravely exacerbated by the closure of those departments. Thankfully, we are eventually going to get our 40-bed unit in South Tipperary General Hospital. We hope that will be before the end of January 2020. Overall, however, we lost 80 beds in the area and we need at least another 40 or 50 in a new block.

The Minister was in Tipperary two or three years ago and he visited Our Lady's Hospital in Cashel, which is a state-of-the-art facility. Some €14 million was spent on upgrading that hospital, but there is not a single bed in it because it has been vacant for the past ten years. It is definitely time for that hospital to be opened because it can and should be able to provide step-down facilities. The expenditure on the hospital was intended to provide district hospital beds, palliative care beds and step-down facilities, but it has been vacant and left in pristine condition for the past decade. The hospital should be opened immediately.

As other speakers indicated, the moratorium - and that is what it is - on recruitment of staff must be lifted. General nurses tell us that 400 staff are needed in their area, while psychiatric nurses estimate that there are approximately 500 unfilled posts. The moratorium on home help hours must also be lifted. The recent increase in the funding for home help hours, well and good as it is, will cater for less than 50% of the existing backlog. Another area in need of urgent attention is GP services and availability. I also want to state that I support the comments of Deputy Paul Murphy and I would also like to see a proper national health service.

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