David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:

recognises that: —there was an alarming rise in healthcare waiting lists from 461,908 in 2014 to 740,712 in January 2020;

—waiting lists have spiralled out of control since January 2020 to 814,345 in August 2021, rising to 907,648 including planned procedures;

—210,740 people are waiting more than 18 months on inpatient and outpatient waiting lists;

—a further 203,976 people are on radiology diagnostic waiting lists for CT, MRI and ultrasound scans;

—more than 98,000 children are on hospital waiting lists, including 31,216 children waiting more than 18 months; and

—children with additional needs are forced to wait on average 19 months for an assessment of need, despite the legal right of three months; notes that: —in excess of €300 million will likely go unspent on vital community and primary care service expansion to ease the burden on hospitals;

—more than 150 promised acute inpatient and critical care beds are unlikely to be operational by year-end; and

—mental health services are not fit for purpose in the context of the looming pandemic mental health crisis; further notes that: —the recent high profile Sláintecare resignations are a vote of no confidence in this Government’s commitment and ability to deliver major healthcare reform; and

—the latest Sláintecare Implementation Strategy & Action Plan 2021 — 2023 notes major obstacles to the delivery of key Sláintecare measures, including a plan to tackle waiting lists; reaffirms its commitment to: —universal healthcare with universal general practitioner care and universal counselling; and

—the removal of private healthcare from public hospitals to free up public capacity for public patients; and calls on the Government to: —urgently implement a waiting list reduction and management plan;

—commit major funding to the rapid modernisation of healthcare information systems,including individual health identifiers, an integrated waiting list management system and a centralised referral system; and

—deliver major capacity boosting measures including additional inpatient and critical care beds next year, a capital fund for expanding theatre capacity, and the modernisation and expansion of diagnostic capacity with direct community access.

We have just had a very lengthy debate on housing where we talked about public land being used for public housing and having a strategy that is not built around developers, landlord and institutional investors. Truth be known, the same argument should, and can, be made on healthcare, namely, that public moneys should be spent on public healthcare services and private medicine should not come before the public good. Yet that is not happening because we have a deeply two-tier health service, where private medicine and the private sector is embedded in the healthcare system.

First we must appreciate the scale of the problem that faces us. We do that in our motion, which I am proposing today. The figures are so stark that it is hard for people even to comprehend them. More than 900,000 people are on some form of health waiting list, either waiting to see a consultant or waiting for a hospital procedure. The big jump in those figures came before Covid, as we know, but has accelerated due to Covid. Of the more than 900,000 people who are awaiting treatment, 210,000 have been waiting for more than 18 months and 31,000 of them are children. There is a human story behind each and every one of those people who are waiting for treatment.

I conducted a survey a number of weeks ago, which I published, in which I asked those who are on waiting lists, sometimes for years, what their experience is. I heard many stories from parents of children with scoliosis who are waiting years for treatment, often in pain. I heard stories of people who are waiting years for orthopaedic treatment and for other procedures, including ear, nose and throat, ENT, and ophthalmic procedures, in areas where we know waiting times are very high. I also heard of the human consequences of people waiting that long. It has an impact on their mental health, their overall physical well-being and their ability to work. Many of them are out of work for too long. My point is there are human consequences and real consequences for people when we have the kind of waiting lists we have.

I wish to go through the Minister's amendment to the Sinn Féin motion. I must say it is weak, to say the least, and it is lame in terms of the excuses the Minister gives. I will provide some examples of this. In the amendment, the Minister talks up some of what was done last year. I accept that investment was made in healthcare last year. The amendment mentions that 795 acute beds were put into the system this year, with a target of 938 that will be reached by the end of the year. The Government funded 1,150 beds last year. Therefore, 204 of those beds will not be delivered. In respect of ICU beds, we had 600 ICU beds in 2009. Even if the Minister delivers what he has said he will deliver, we will fall way behind on where we were then.

The amendment mentions community intervention teams. What the Minister forgets to mention in his amendment is that of the €150 million he provided for enhanced community services last year, only around half of that money is anticipated to have been spent. The Minister took to his feet last year and said we were going to recruit 14,500 people into the Irish healthcare system. That figure has now been revised down to around 7,500. Only around half of the staff promised by the Minister have been recruited. He cannot hide behind Covid, or anything else for that matter. He was the one who made that promise. Covid was with us when the Minister put those figures out there, provided the funding and made those commitments. He simply has not delivered.

In the remainder of my time, I must say there are huge challenges in healthcare and there are big decisions that have to be made. We have had high-profile resignations in Sláintecare, which I reference in my motion.

That cannot be seen as a vote of confidence in the Government's ability to deliver the big changes.

One of the areas where we must collectively stand our ground concerns public consultant contracts. Consultants who work in the public system have to do public work. The other big changes, involving removing private medicine from public healthcare and moving to universal GP care, also must happen, but they are happening at a snail's pace. They are not happening anywhere near quick enough. If we do not make these big changes, more and more people will become disillusioned and put on waiting lists.

On the Government's promise to have multi-annual waiting list targets and a plan to make this happen, unless there is a centralised referral system it will not work. Unless there is an integrated waiting list management system, it will not work. Unless the capacity is put in place, it will not work. I could wallpaper this room, as could the Minister, with all the waiting list management plans of successive Fianna Fáil and Fine Gael Governments. These plans have not worked because they were not backed up with capacity.

The Minister should think about the victims of long waiting lists. Those children and adults who are waiting years for treatment are the ones for whom we have to deliver. They are the people who are at the front and centre of why we moved this motion.

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