David Cullinane (Waterford, Sinn Fein) | Oireachtas source

This is my first time, as the Sinn Féin spokesperson for health, to exchange with the Minister for Health. I wish him well. There are significant challenges in healthcare that we, collectively, have to deal with in the coming weeks, months and years.

We will support the Bill and have supported its quick passage through the Houses. Nevertheless, given the crisis in both primary and community care and acute care settings because of Covid-19, and the need to deal with Covid care, non-Covid care and what many are now calling the catch-up programme to deal with mis-care, we need rapidly to ramp up investment in our health services. I would have much preferred if the Minister had spelled out to us where that investment is going to come from, that is, where the additional investment in community care, primary care and acute care will come from in the coming weeks and months.

I am not sure whether the Minister watched the "RTÉ Investigates" programme last night. It laid bare again the extent of the crisis in our health system and what front-line workers in all healthcare settings are facing, from supporting older people and acute hospitals to primary care, right across the board. It showed that because we did not invest in community and primary care to the extent we should have over the past decade, we have been left with an acute care system that simply cannot cope. Imagine if we had invested in the primary care infrastructure that we in Sinn Féin called for and if we had more GPs working for the HSE and better community infrastructure that could deal with diagnostics, for example. It would take a great deal of pressure off our acute systems.

The Bill is welcome insofar as it will extend GP cover to more sections of society. Some 150,000 children aged between six and 12 already have access to free GP care and the Bill will extend that service to about 300,000 further children, which we support. It will also provide for an increase to the gross medical card income limits for people aged over 70, which will benefit about 56,000 people.

What we now need to hear from the Minister is what will come next. One aspect of the programme for Government that puzzled me, and it is something the Government needs to clarify, is the several references to affordable care - not universal care but affordable care. We all know there is a big difference between universal healthcare and affordable healthcare. We were promised by the previous Government that it would implement what was in Sláintecare, that we would have a new dispensation in healthcare that would finally separate private from public healthcare, that people would be treated on the basis of need and that there would be a health service that was truly equal and accessible for all citizens. We do not have that, however, and we are a long way from it. One of the first steps I took when I became the health spokesperson for my party was to read Sláintecare again and the implementation reports. Any objective reading would suggest we are a long way from the targets that were set, and that was before Covid struck.

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We are discussing expanded GP cover in this Bill so I will mention some of the measures that could have been in the legislation. For a long time my party has called for all cancer patients to have a medical card. I remember when we called for this in the past the previous Government argued that if it was done for cancer patients, it would have to be done for other patients. We want to see free GP care for everybody and we have a plan to do that over five years. However, a bit like what the Government is doing in incrementally rolling out free GP care to children who are under certain ages, we must start somewhere. A good start would have been those patients with cancer.

My mother passed away from cancer two years ago. I remember when she was first diagnosed the shock it was to her and the family. Every one of us knows people who have, unfortunately, developed cancer and the trauma that brings to families. The last thing they need to worry about is the additional medical costs. For all the heartache, trauma, care and treatment they must face, it is wrong that they must also worry about costs. The cost to the taxpayer of doing this is approximately €40 million. The Minister supported this when he was in the Opposition. It would mean 14,000 cancer patients would have access to medical treatment free of charge. It is one of the first things that should be done by this Minister and his Government in the expansion of GP care.

As we reflect on the commitments made in Sláintecare and seek to deliver a new healthcare system that addresses health on the basis of need rather than ability to pay, we must hear the Minister's plan as quickly as possible. What will the Minister for Health do to accelerate the implementation of commitments that his party signed up to along with my party and other parties in this Chamber?

I know we have a big challenge with the Covid-19 crisis. There are a number of big challenges that face the health service as we speak. We must deal with the ongoing Covid-19 crisis and people will need care if they contract the virus. We must prepare for a potential second wave or surge, which would put major stress on our healthcare system, which was unable to cope even before the virus struck. We had people waiting on hospital trolleys and waiting far too long for hospital treatment. People were waiting more than 15 months to see a hospital consultant. I could give the Minister a long list of specialties in this category in my constituency of Waterford, including orthopaedics, with people waiting two, three or four years simply to see a consultant. This was the reality before Covid-19 struck. We must still be able to deal with all the patients who must be treated if they contract the virus.

We must also deal with the existing non-Covid care that should happen anyway, and we have to catch up on missed care. There is absolutely no way this can be done with current capacity. Nevertheless, I do not see any plan from the Government to tell us where the additional capacity will come from. Where will we get the required beds, staff and diagnostics? Where is the plan? It is months since the election, although the Minister is only weeks in his job. Parties have had much time to reflect on what is needed. This is an urgent matter and if the Minister had seen last night's programme, he would know how urgent it is. Nevertheless, no plan has yet been published by the Government as to how it will inject serious capacity into the health service to ensure people do not die.

Cancer screening services, including bowel and breast cancer screening, must get up and running as soon as possible. If the Minister listened to the contributions to Covid-19 committee some days ago, he would have heard the advocate groups crying out for help. They argue that if services are not rolled out quickly, there will be many missed diagnoses and people will die as a result. The Minister would accept that this is not scaremongering; it will be the reality if we do not inject serious capacity into the healthcare system.

I support the Bill and its intentions. Regardless of the who became Minister for Health, we would have had this Bill before us. However, the Minister must come forward with a plan very quickly. Whatever about the cost, the Minister should agree that such a plan must come about. If we do not build modular units or capacity in community care very quickly, and if we do not get more beds into acute hospitals, we will have a crisis in healthcare in the State that we have never seen before. It is the reality facing us. We know it. People will die unnecessarily if we do not do the right thing. I want to see more urgency from the Minister and his Government. I want to see a plan very quickly.

There is no point in any of us slapping front-line workers on their backs, telling them how great they are, if we can see the significant stress they endure and the lack of the capacity in what they need to treat patients and keep people alive. We would not be doing our job in that case. We know what they will do, what they are capable of doing and what they have done in this crisis. We have our job to do, which is to ensure they can keep people safe and treat people. They will not be able to do that unless the Minister provides serious funding and capacity in the time ahead.

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