David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I am sharing time with my colleague, Deputy Patricia Ryan. I will take ten minutes and she will have five minutes.

I have said to the Minister on a number of occasions, and I think he has accepted it because it is a statement of the obvious, that we are facing a very difficult winter. The onset of Covid has been tragic in many ways for our health services, not just in terms of trying to battle Covid and save people's lives but also because of the impact it is having on non-Covid care across a range of areas. We need to get it right as we try to strike a balance between protecting people against Covid and maintaining all critical non-Covid care. We would both agree that we are facing into a very difficult winter for our front-line staff and patients.

The Minister will have seen from the most recent figures from the National Treatment Purchase Fund that we now have record numbers of people waiting to see a consultant and get into the system, and people are also waiting for treatment. We need urgent resources and an injection of serious capacity. We needed a serious long-term plan that would deal with the challenges we face. There is some additionality in the Minister's plan, which I welcome, but much of it resembles more of a wish list. It lacks urgency and ambition.

In the first week of August, I launched the Sinn Féin proposals. We launched a plan that would succeed, not a plan that was designed to fail. We called for 1,100 additional acute beds between now and the end of the year as well as all necessary staff, a proposal that was completely costed and funded. We also called for 2,500 additional staff between now and the end of the year to take the pressure off front-line staff who we know have worked extremely hard and face very real difficulties and challenges. We committed to €50 million in additional spending on cancer services and, separate from our plan, we also talked about additional resources for disability services, mental health and other areas. The Minister's plan for most of those areas has been underwhelming.

I have listened to many stakeholders, including health trade unions and advocacy groups. Over the past week alone, I have met over 20 groups. I have listened to what they have to say because they are on the front line advocating for patients across a range of areas. The one thing that keeps coming up is that this is a temporary plan with temporary sticking-plaster solutions. While that is in part because of the winter challenge, there was an opportunity to make sure all of the additional beds which are being provided would be provided on a permanent basis. In our plan, we provided for 609 modular rapid-build units. The work could have been done during the summer and the beds would then have been ready to be opened in the winter. We would have them on a permanent basis in our health service, which is what we need. Temporary solutions do not cut it and are not what was promised in Sláintecare. They are not what any of us were promised when we canvassed for people's votes in the most recent election.

There are no targets in the Minister's plan in terms of staff. There is no mention of staff in the plan. In the press conference, that information had to be dragged out of some of the people who were there. The plan is still lacking in targets. How many staff will be recruited and how they will be recruited? Will they be agency staff? How long will they be employed for? What type of contracts will they be on? I refer to doctors, nurses, consultants, medical scientists and so on. We know the winter plan is only funded to the end of April and will not, therefore, be a medium-term to long-term solution for all of the challenges we face. In my view, it does not go anywhere near enough to deal with the challenge we have in delivering Covid and non-Covid care. This is a winter like no other. This is a winter when we have to deal with Covid and non-Covid care. However, there should be some opportunity to catch up on all of the missed care.

I have listened to cancer patients who have not had access to their consultants at the times they were promised. Their appointments, procedures and surgeries have been cancelled. I put down a parliamentary question to the Minister on children with scoliosis, a matter which he quite rightly raised with other people when he was in opposition. It is a fundamental issue of children who are in pain and need treatment. There was a 30% reduction in medical procedures for children with scoliosis for the first eight months of this year compared to the first eight months of last year. That is obviously because of the Covid restrictions, but it is all the more reason why we need a catch-up plan, investment and resources to ensure children with scoliosis and cancer patients are not waiting longer for treatment.

The plan made no mention of disability services. It failed to provide additional funding, resources and investment for disabilities and dementia services. The Minister has since announced a meagre €10 million for these services, which was met with shock and disbelief by all of the advocacy groups representing people with disabilities. I very much hope that they will see much more from the Minister, and the Ministers for Public Expenditure and Reform and Finance, on budget day because this is an area that deserves a lot of our attention.

The Irish Cancer Society has said we need €40 million for cancer services. All the Minister has provided in the winter plan is €2.3 million in additional funding next year to deal with what he called restarting or kick-starting cancer services. That falls far short of what is needed for us to be able to make sure oncology services are operating at the same levels that they were pre-Covid.

I do not underestimate the challenge, but there is another important area I want to raise with the Minister. For the past number of weeks I have compiled as much data as I can on dental and orthodontic wait times, which are beyond shocking. Children are waiting four and five years for services. I have received emails from the parents of children who are in extreme pain and cannot get the treatment they need. I do not know whether the Minister has looked at the waiting times recently, but they are shocking. It is one of the areas where there was a pause in treatment. I know people who are not even being referred for treatment; they are instead being told a referral cannot be made because of the lack of capacity. In the Be On Call for Ireland waiting pool of 1,600 staff, there are dentists and dental assistants. Why are they not being hired and brought into the public system to ensure we can treat people and make sure children get the treatment they need? That is the point.

We have to live with Covid, as I said, but we also have to live with it in a way that non-Covid-related healthcare can be delivered. We are saving lives, which we need to do in terms of Covid and taking all of the necessary precautions. On the other hand, people are waiting far too long for cancer treatment, children are waiting too long for all sorts of medical treatment and across whole range of areas, from cardiology to neurology and many others, we have longer and longer wait times. Over 600,000 people in the State are waiting to see a hospital consultant. I can guarantee that by the end of the year, given the lack of urgency in the plan, that will get worse because the Minister has not provided for measures to deal with that.

The plan lacks the detail, ambition and urgency needed to inject the capacity that is needed. The Minister knows full well that if we are to have any chance of catching up or, if we are to be brutally honest, any chance of keeping up we need far more beds than are being delivered in the plan. The Minister has put more pressure on acute hospitals to find whatever space they can in their hospitals to open up beds . There are no new builds whatsoever. There is no reference to modular building, or to medium-term or long-term planning. The plan is about what can be provided by acute hospitals, which are bursting, and putting them under pressure to get all of these beds in place which will of course all be closed at the end of April. We will be back to where we were with a lack of capacity in the system.

I want to finish on an issue I have raised several times with the Minister. It has been raised on the floor of the Dáil with the Taoiseach. I refer to cardiac services in Waterford and the south east. There is very real concern about the second cath lab that was promised which will now only deliver diagnostic services. I attended several meetings with senior officials from the Department of Health, the previous Minister for Health and others where we were promised that the lab would provide interventional and diagnostic care.

That needs to happen.

The final point I will make in the 30 seconds remaining is that I, as a Waterford Deputy, want to work with this Minister for Health, so that he can be the Minister that delivers health equality for the south east, and delivers the 24/7 cardiac care people want. He has it within his power to work with those in the Department and the HSE and with others to make that happen. He knows from his colleagues and others in the south east that this is not just a Waterford issue but that this is needed. I appeal to the Minister to work with others on this issue and to be the Minister for Health who delivers that facility for the people of the south east. Gabhaim buíochas.

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