Michael Lowry (Tipperary, Independent) | Oireachtas source

The wealth of a nation is said to depend on the health of its citizens. There are many aspects of the budget today that I welcome. There are also aspects of the budget that we as rural Ireland would have huge concerns about. In the short time available to me I will focus on the health service.

When taking into account that line, "The wealth of a nation depends on the health of its citizens", Irish citizens are among the poorest in the world. In fact, we rate 80th out of 89 countries in providing health services to our people. While we continue to pour money into the HSE, our health system seems to get poorer. The HSE is simply not fit for purpose. It is top-heavy with managers while way too few hard-working healthcare staff struggle every day to provide care at all levels across the country. Sláintecare is running into the sand. Reform is obstructed by vested interests within the system. It screams "Do not disturb" and "Hands off". Too many people within the system are determined to throttle and to choke change because it would impact the current arrangements they have. The HSE has wasted scarce resources. There is constant duplication and overlapping. It is impossible to get through the layers of bureaucracy. There is little or no transparency or accountability. Issues are dealt with in such a way that they are everybody's problem but nobody's problem. The public dealing with the HSE finds it frustrating, irritating and incredibly time-consuming. It is obvious to most people that the HSE is dysfunctional. The catalogue of neglected patients is rising sharply. Our courts are busy with medical litigation. Thousands of new challenges to hospital management are inevitable. Staff in our hospitals are working under extraordinary pressure. The stress and strain of the workload is resulting in sick leave and acting as a deterrent to recruitment. The consequences for delivery of proper healthcare are stark and alarming.

Today the Government allocated €22 billion to health. That should be good news for people, yet the reality is that people right across Ireland live in abject fear of needing healthcare. The funding is there; the ability to manage it is what is lacking, and people out there know that. Year after year, the funding allocated to the HSE fails to deliver the services the people need. In 2017, a record budget of €14.6 billion was allocated to health. The lion's share of that was destined for the National Treatment Purchase Fund to tackle waiting lists. Some €35 million was allocated for mental health services on top of the same amount allocated the previous year. The question has to be asked: what have we to show for it? Where are the results of that additional expenditure? Year after year, the Government throws good money after bad. Not once have I seen the HSE deliver value for money, and I deal with the public every day about the health system. It is time the HSE was checked and time we had accountability. That hard-earned money comes from the taxpayer the length and breadth of Ireland. It should have shown results by now. We have not seen them.

Going through the system, the shortage of GPs and the inability to recruit new ones means that the basic health needs of our people are suffering. Waiting lists for primary care and hospital care for adults and children are growing. Mental health services remain chronically deficient. Elderly people cannot get home care due to an inability to hire and to retain staff. The worries and fears and elderly people about being evicted from their nursing homes is, as in the case in my constituency of Dean Maxwell, in Roscrea, both pitiful and totally disgraceful to witness. The ambulance service has become a joke as ambulances criss-cross the country to attend to patients' emergency needs. It was revealed last week that there was an underspend at the Department of Health for the current year. The reason given is that the hiring of staff by the HSE was slower due to both the pandemic and the hacking of the HSE data system. Yet the HSE comes out and claims it has hired more staff this year than ever before. The figure still fell short of its target of 14,000. In fact, it fell short by 10,000 and only 4,000 healthcare jobs have been filled. It sounds incredible, but the HSE has claimed it will hire between 7,000 and 8,000 people before the end of the year. We are now in October. How can the organisation stand over such a ridiculous statement?

While the HSE continues to hold the purse strings, we are simply squandering vast amounts. We are getting the lame excuses we have always got as to why funding is not available for vital services and community health projects. Hiding behind the pandemic and the data breach is not an acceptable excuse for the dismal state of our health services. While those events can be held partly accountable for the backlog of patients on waiting lists since March 2000, figures I obtained go back to more than 18 months before the pandemic. In County Tipperary, 449 adults have been awaiting treatment at Nenagh Hospital along with 26 children for more than 18 months. University Hospital Limerick had an inpatient day case waiting list of 400 adults as well as 20 children.

The ambulance service is in a serious state of disarray. Too few people know or understand exactly what is happening. A massive shortage of paramedics in many areas, particularly the south east, is at the root of the problem. Recently in that area there were at least 78 shifts without cover, while in the same week there were 55 shifts without cover in the mid-west. In addition to the shortage of paramedics, the agreement to have a 20-minute turnaround at hospitals is a farce. Crews are spending up to four hours outside emergency departments waiting to hand over patients, leaving them unavailable to respond to other calls. The current priority dispatch system is not fit for purpose. The only key performance indicator measurement in the ambulance service is the time between the receipt of a call to the dispatch centre and the mobilisation of an ambulance crew. The European standard deems that this should be within 90 seconds. Once a crew anywhere in the country responds within that 90-second timeframe that it is mobile, the call is deemed to be 100% successful. The time it takes to arrive at the scene is not reported or recorded. The ambulance service, therefore, applauds itself for working 100% efficiently, yet the patients, particularly those in rural Ireland, are left waiting unacceptable times for urgent medical care.

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