John Brassil (Kerry, Fianna Fail) | Oireachtas source

I compliment Deputy Harty on this Bill and his invaluable work as Chairman of the Joint Committee on Health. I welcome the opportunity to speak on the Bill.

Fianna Fáil's priority is to put in place permanent and sustainable improvements to our health service. For us the focus must be on what needs to be delivered and what is deliverable. We are committed to a strong public health service where the impact of public expenditure is optimised. We want quality services to be as close to people as possible and where all can benefit from new opportunities for improved care.

A public health system funded from taxation is more progressive as it ensures that healthcare can be prioritised for the most vulnerable and those who cannot afford to pay for their care. We accept the good intentions and motivations behind the Bill and given the current crisis that patients are enduring in our hospitals, it is understandable that people might wish to amend the Constitution. However, more debate is required and we accept the reasoned amendment put forward by Government.

Action, not constitutional amendments, is what is needed. We need investment, reform and real political commitment to ensure we have the health service that people deserve. The sentiments expressed in the wording of the proposed amendment are entirely in keeping with what Fianna Fáil believes we should be doing in health policy. We are committed as a party to the realisation of economic, social and cultural rights for all citizens in the State. We should all strive towards that goal. We recognise that many people are living at the margins of society due to poverty and social exclusion and that this has an impact on health outcomes. The failure of the Government to deliver on health provides a powerful argument for a constitutional amendment, for those failures are many and widespread.

The latest waiting list figures show that 178,320 have been waiting over a year for an outpatient appointment. Some 10,262 people had waited for more than a year on the inpatient day-case list in Irish hospitals last month. This contrasts sharply and very unfavourably with the National Health Service, NHS, in Britain where the waiting times for consultant-led treatment show 1,233 waiting more than 12 months.

A total of 13,466 people aged over 75 have waited on trolleys or on chairs in emergency departments across Ireland since the start of the year. The patient experience survey published yesterday showed that only 2,347 people, representing 30% of those who responded, reported waiting less than six hours in an emergency department before being admitted to a ward. The HSE recommends that the time spent in the emergency department should be less than six hours. The large majority, that is, 5,580 people, said that they waited more than six hours before being admitted. Of those, 331 people reported waiting 48 hours or more before they were admitted to a ward. Those 331 people sat on chairs or in beds on corridors for more than two days, which is shameful.

The pressure on the system in hospitals has resulted in a severe deterioration in ambulance turnaround times with paramedics being delayed in hospitals, preventing them from getting to new cases. The number of bed days lost so far in 2019 as a result of delayed discharges stood at 197,160 at the end of October. That is almost 200,000 bed days that could have been used to treat patients.

Figures issued by the Irish Nurses and Midwives Organisation show that for only the second time ever, the number of people on a trolley has surpassed 100,000. Frighteningly, this also includes almost 1,000 children. A total of 17,463 children are on a waiting list for hospital appointments. Shockingly, 30,600 of these boys and girls have been waiting for over a year.

On Monday, there were 85 people on trolleys in University Hospital Limerick, breaking the daily record, the highest figure ever recorded in an Irish hospital in a single day. This morning, it was reported that the country's three main children's hospitals have begun postponing elective procedures due to mounting pressure on the system ahead of the peak winter months.

With all this happening, it is entirely understandable that some would argue for constitutional change. However, at this juncture we do not regard this Bill, which would explicitly enshrine health rights in the Constitution, as the appropriate mechanism to address these issues. As Fianna Fáil has pointed out previously in this Chamber, Bunreacht na hÉireann, our 1937 Constitution, makes only limited reference to economic, social and cultural rights which are, by and large, referred to in Articles 40 to 44 of the Constitution. However, the courts have recognised that personal rights are not limited to those expressly set out or enumerated in the constitutional text.

Changing this to explicitly enshrine health rights in the Constitution is not the problem per se. The issue is how we define such rights and also the limits of such rights, while also having in place effective and efficient methods for the enforcement of those rights that this Bill would enshrine in the Constitution.

A fundamental issue that arose during the debates on this matter at the Constitutional Convention was whether enshrining socio-economic rights would mean handing over decisions on the allocation of Exchequer resources from the Oireachtas to the Judiciary.

This is a key question and requires further investigation. Another element would be the implications such a move would have for our court system. Would it result in a significant increase in the number of cases being taken against the State? What are the unintended consequences of enshrining such rights in the Constitution, including the financial burden that it could place on the State? Would it take responsibility for the allocation of resources from the Government and responsibility and power from the Oireachtas and, in particular, the Dáil for which people vote freely at election time? While laudable in principle, this Bill does not have specific definitions or clear proposals. Before such a change should be introduced, we need a thorough and careful analysis of what such a move would mean for the individual, society and the State as a whole. While economic, social and health rights should be viewed as more than an objective or noble ideal, the practicalities and consequences of embedding such rights in our Constitution cannot be discounted or neglected.

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