Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I thank Sinn Féin for bringing this motion forward. It is very timely. I apologise for not being present for the start of the debate. I had a scheduled meeting with Care Champions, who the Deputy and members of his party have met. They are relatives of people who passed away in nursing home care in the last 18 months and, with the indulgence of the proposers of the motion, I ask the Minister to engage with the group. I know the Minister of State, Deputy Butler, has done so. I am still absorbing the half hour that I was on the call with them. It was very powerful.

This motion is very important and timely. Again, I thank Sinn Féin for proposing it. There are currently 652,344 people on an outpatient waiting list, an incredible number. Some 263,354 of these have been waiting on a list for more than 12 months. What is even more shocking is that since January 2020 the number of people who have been on a waiting list for more than 18 months has increased by over 80%, from 107,000 to 192,764. It is very hard to conceptualise these numbers. We could say it is two or three Croke Parks or whatever, but it is a huge number. These are people in our lives whom we know personally, not to mention the countless people who contact us through our constituency offices. They are not just numbers on a page, but real people with real conditions who need treatment. With every passing day and week they are getting further away from the treatment they need, with their conditions in many cases deteriorating in that time.

It is not a problem that is exclusive to one part of the country. Five kilometres from here there are 45,000 people on a waiting list for the Mater hospital. There are 60,000 waiting for treatment in University Hospital Galway, 48,000 are waiting to be seen in University Hospital Limerick and in Cork, the Taoiseach's city, 36,700 are waiting in Cork University Hospital, 26,000 in South Infirmary Victoria University Hospital and 7,500 in the Mercy University Hospital. Age does not appear to be a discriminatory factor in whether one is on a list, with over 12,052 children waiting to be seen by an ENT service. Shockingly, there are 71,369 adults waiting to get orthopaedic treatment, accounting for over 11% of those on waiting lists. That is so wrong. In terms of orthopaedic treatment, we think about mobility.

Make Way Day last Friday was one of those days where we got to shine a light on the impact of the obstructions of everyday life for people with mobility issues and those who are using wheelchairs.

Whether it is a young girl in County Kerry suffering from scoliosis who has been on a waiting list for 18 months or a man in his 70s waiting for hip replacement for more than a year, the State should not be keeping people on a waiting list for significant periods. Never before in the history of the State have so many people been on waiting lists. Unless the Minister takes action, this will spiral further out of control.

Staggering waiting lists are not a symptom of the Covid crisis. It may seem like a long time ago, but this was a major problem with our health service long before the pandemic. Unfortunately, our health service was always described as being in a crisis - throughout my lifetime at least. While we have been dealing with a pandemic which is an enormous crisis in itself, we are now returning to the pre-crisis state of our health service. As we come out on the other side of the pandemic, we are faced with a broken health service.

The sad reality is that the Government thinks the National Treatment Purchase Fund is the be-all and end-all that will solve all our problems. The NTPF was established by Mary Harney on a promise that it would deal with waiting lists, that we would move beyond it and that we would not need to use it in the future. It has now become a crutch. Successive governments have promised to end waiting lists, but the reality is that as the drive towards a two-tier health system continues unabated, the NTPF will be a fundamental tool used by the Government which is wrong.

Thanks to Fianna Fáil's and Fine Gael's ideological commitment to for-profit medicine, there is a danger that those who can afford to pay get the best attention while those who cannot end up on waiting lists. We see it in many different areas of care. Families with children awaiting speech and language therapy are being forced early in the child's life to go private. It is only €150 or €200 for an initial consultation. People will scrimp together and get that initial consultation, but of course after that there is further care and suddenly they find themselves in the private healthcare system. They cannot afford to be in the private healthcare system, but they have been led there and because it is their child and they want the best for that child, they will do everything they can. It is fundamentally unfair; it is not good practice and it is not providing the solutions we need. We need a patient-centred healthcare service that caters to the needs of the individual regardless of their ability to pay.

There are different types of waiting lists. Today's Irish Examinercontained a very harrowing story about Emma-Jane Stoker-Phelan who has suffered from anorexia for the past 12 years. She said she feels like she is "slowly dying" due to a lack of services. Bodywhys has pointed to a 60% increase in hospital admissions for people suffering from eating disorders. We need to ring-fence money in the budget, but we need to ensure that mental health gets the funding it desperately needs.

We need to move our system to a more community-based system. If we can treat people in the community, they will not be on waiting lists for our main hospitals. They will be getting the treatment they need where they need to be getting it. For areas like this, which seem to be on the fringes of healthcare provision, it would make a major impact on our overall healthcare system if we can deliver that model and if we can deliver this care where it is needed.

We cannot keep trundling from crisis to crisis in our health service. It is always one thing after another. Staff and patients in our hospitals are incredibly frustrated by what they perceive to be the hands-off approach of this Government and the previous one to solving the waiting list crisis and the trolley crisis. The funding of our public health service must now be multi-annual and focused on investing in and retaining all staff - doctors, nurses, midwives, healthcare assistants, porters and medical scientists. The professionals in our healthcare family are multifaceted and we need to recruit them and retain them. There are too many long-term vacancies across a swathe of healthcare jobs and that issue needs to be tackled.

It is depressing that every time we mention a health-related issue in this House, it is followed by the word "crisis". Until we do something about it, that will always be the case. As we all know, it is not the fault of the amazing workers in our health service. It is incredible that over the past 18 months the HSE has been on flags and bunting hung out of people's windows as a source of pride. That is the first time that has happened in my lifetime because people have really felt connected with their front-line workers and all workers in the health service. We are in danger of losing it but we cannot lose that. The way to ensure we do not is by investing in the system and trusting the great professionals in there to improve and increase the care they provide. If we do that, we will tackle the waiting lists.

We are still a small country, but we are a rich country. We should not have these crises. We should not be rolling over and accepting every year that we will have debates about waiting lists and access. We can solve this. Hopefully, the Minister can solve it and not leave it for subsequent governments.

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