Dáil debates

Thursday, 15 October 2020

Financial Resolutions 2020 - Financial Resolution No. 7: General (Resumed)

 

1:20 pm

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein) | Oireachtas source

I am sharing time with Deputy Kerrane. The crisis in health at the moment is a battle on a number of different fronts: dealing with Covid care, non-Covid care and all the missed care across a whole range of specialties. This has resulted in 613,000 patients today in this State waiting to see a hospital consultant and 850,000 patients waiting either to see a consultant or for an inpatient procedure or medical support. As context or background, we also have a decade of underinvestment from Fine Gael and Fianna Fáil. What we needed in the budget was a response and action on all fronts. If I was Minister for Health, I would have made sure we had at least 100 additional ICU beds and at least 1,100 new inpatient beds.

As always with the Government's budget, the devil is in the detail. Going under the bonnet of what it says in the budget and the reality of the ground, it is very different. Regarding the 1,100 acute beds that we were told are additional, in fact they are not. It is 1,100 additional beds over two years, and not one year. It is only 500 additional beds on top of what was there at the end of last year and, in fact, it will only be 197 additional beds on top of what would have been there at the end of this year compared with what will be there at the end of next year. That falls far short of what is required and will not enable our healthcare system to deal with the real challenges that it faces.

The Minister for Health and the Government made great play about the fact that this is a spectacular health budget of €4 billion. It is a lot of money, of course, but it has to be pointed out that most of this money is one-off funding to deal with Covid.

Some of it is to deal with demographics and pay but an enormous amount of that money is to deal with personal protective equipment, testing and tracing and infection control measures. All of that must happen and we provided for it in our budget. When one looks at the core additional supports, services, staff and beds, the budget is less ambitious than the headline figures would have one believe.

It is also the case that there is double counting and smoke and mirrors applied to the deliverables and what has been said. I spoke to a number of hospital managers over the course of the past few days who told me that the 1,100 magic beds that the Minister has talked about cannot come unless there is capital funding and additional physical space. The additional capital funding for health in the budget was €25 million. It is not possible to deliver all the beds that the Minister says he wants to deliver. The plan is even less ambitious than he was trying to portray in the Budget Statement. This budget will fall short of what is needed to make sure that our front-line staff and health services are equipped to deal with the battle on all fronts about which I spoke earlier.

There are some welcome investments in health that I acknowledge, some of which relates to national strategies. The Leas-Cheann Comhairle will remember that we had a Private Members' motion in this House on cancer care. I worked closely with the Minister for Health and others to ensure that we secured additional funding for cancer services. I am pleased that €32 million of additional funding has been given to the area, €20 million of which will go to support the national cancer strategy with the remaining €12 million to kick-start cancer services. It is short of what we in Sinn Féin proposed, but it is a significant increase. There was also additional funding for the national maternity strategy and other national strategies. That can and should be supported.

I must also point out that there was some cut-and-paste and copy-and-paste in the Government's plan, based on last year's budget. The Government again wants to take credit this year for reducing prescription charges and expanding the medical card for the over-70s. Those measures were in last year's budget, were funded and not delivered. The exact same measures were in this year's budget. They have been funded this time but let us see if they are delivered.

What we got from the Minister for Health is not a plan that is detailed, worked out and shows that he knows where the beds are and where the additional staff are going to come from. This is a plan to develop a plan and that is not what a budget should be. A budget should be a plan that will deliver.

At the heart of all of this are patients and people. The reality is that 613,000 people are waiting to see a consultant. Some 850,000 people are waiting either to see a consultant or to get a hospital procedure. Those are the facts and realities of a decade of underinvestment by previous Governments. The three-card trick that the Government has played here by putting all of the Covid expenditure into the Department of Health and claiming it is all new money in the health service when, in fact, most of it is one-off funding will be rapidly exposed for what it is. If I were the Minister for Health, I would have made sure that the 100 intensive care unit, ICU, beds that are needed would be there. The Minister knows that there are fewer ICU beds in our acute hospitals today than there were ten years ago. We are in the middle of a pandemic where the virus attacks people's respiratory systems and they need to be treated in an ICU. That has happened on the watch of Fine Gael, Deputy Varadkar and the Taoiseach. They allowed that to happen and have not put enough beds into the system.

I am not interested in wish lists, magic numbers or the smoke and mirrors we have got in this budget. I am interested in real plans and strategies that work and deliver for patients and front-line staff.

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