Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Budget 2021 will be judged by the way it impacts on citizens' lives, whether it improves, disimproves or has no impact on them. It is important that we talk about real citizens. I want to give the Minister an outline of a letter I got today from a constituent. He says that he is in agony. He has problems with his cervical spine, which he says is busted, and his lumbar spine. He has been told by neurology and rheumatology that he needs a scan but he has also been told that he may have to wait years for that. If he had money - he is on a disability payment while his wife has a long-term illness also - he would probably be able to get a private scan tomorrow. Two private scans would cost €700 but it may as well be €7 million because this man does not have that money. He has been forced to go to the Society of St. Vincent de Paul to see if it will cover some of the cost. I asked him if he was in pain. Doctors normally ask patients to describe their pain between one and ten, one being an ache and increasing to ten depending on severity. This man says he is in agony, and he is looking for help in that regard. That is an example of one section of our population that we are failing.

The Covid-19 pandemic should have been a wake-up call for the Government to see that our health service was woefully under-resourced and unprepared for a major crisis. It highlighted a weakness whereby politicians, but also senior management, seemed unable or unwilling to change elements of policy that were not working or needed immediate attention. We have seen that with the private hospitals not being fully utilised or put on hold during the early days of the pandemic. We saw the expensive accommodation and facilities in Citywest not being used in any serious way. There was no flexibility in that regard. This is a facility that has to date cost up to €21 million. When the owners bought the hotel it cost them €24 million. Again, we see an issue with the use of public moneys. In terms of moneys allocated to the health service in budget 2021, it is simply noise until we hear the detail on how it will be spent, or misspent. I refer again to the man who wrote to me and the difficulties he is experiencing.

No one would have foreseen the extent of the Covid pandemic but we had warning signs in previous years. Swine flu and bird flu caused health professionals to highlight the weaknesses in our system. Even the seasonal flu outbreaks caused major strain in our capacity to provide healthcare to our citizens, with accident and emergency departments filled to brim every year with people on trolleys for days at a time.

We need a budget that is fit for purpose in terms of building up our hospital bed capacity, not only to deal with the realities of Covid but with a growing and ageing population. Budget 2021 provides for an additional 66 ICU beds but that is only one quarter of what we need to put into the system to be at a proper bed capacity level. That is not a new figure. In 2009, 11 years ago, the HSE commissioned another expensive report that told us we would need 579 ICU beds by 2020. When Covid struck, we had only 255. The Minister was in the House the other day and he said that additional beds will be provided. We know that a lack of ICU beds is not just a problem during the pandemic but is a bottleneck within the system where critical care is needed for elective surgical procedures. Far too often we hear constituents talking about life-saving elective procedures being cancelled at the last minute. What is happening to people is cruel and wrong.

I cannot understand the reason medical cards for the terminally ill were not provided for in budget 2021. There is support in this House from all parties, and none, for that measure, which was promised last year by the previous Minister for Health, Deputy Harris.

In my constituency, surgeons from Tallaght hospital have been taking to the airwaves to plead with the Government to build up facilities and support with regard to ICU beds. We cannot wait years for that. People cannot wait much longer. We need changes now.

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