David Cullinane (Waterford, Sinn Fein) | Oireachtas source

It is a sad reflection on our health service that many people cannot access a GP. As the Minister knows, in some parts of Dublin and in some rural areas, people cannot register with a GP because of a shortage. We are now seeing waiting lists and waiting times for GPs. In the past, people could contact their GP and get an appointment that day or within two or three days. That is now being pushed out to a week or longer. Out-of-hours GP services are inaccessible or not available to far too many patients. That is putting great pressure on our emergency departments because people are going to them when they do not have access to out-of-hours GP services. Dentists are leaving the dental treatment service scheme for medical card patients at a rate of knots. I know many medical card patients who cannot get access to dental treatment. Far too many patients cannot get access to a hospital bed. They are on trolleys. As was said earlier, the first case of a patient on a trolley was in 1998. There are now hundreds of patients on trolleys every day, as if it is normal that they cannot get access to a bed. We have ambulances parked up outside hospitals. Their patients cannot be transferred into the hospital because beds are not available.

We also have ambulance paramedics and front-line staff who are stressed out and burnt out. One of them described it to me as hell. We do not appreciate the kind of calls they have to attend. They have to deal with children who are sick and children who are dying. They have to cut people out of cars. They tend to people who are reaching the end of their lives after an emergency or an accident that happened on the side of the road. They are the people who go out to respond to those calls. They get up every single day to their job and keep us safe. When they tell us the system is not fit for purpose and that it is unsafe - and they have been saying that to me right across the board from middle management to ambulance paramedics and emergency medical technicians, EMTs - we have a responsibility to listen. They often do not get downtime after attending to a greatly distressing call or accident. Moral injury kicks in. They just need time to recover. A child or older person may have just died. The ambulance personnel may have just been at the scene of a horrific car accident and then, within five or ten minutes, they have to respond to a call somewhere else because of the pressures on the system. That is unacceptable.

Ambulance paramedics have to eat their lunch on the dashboard of the ambulance because they cannot take the time to eat. They are doing 12-hour shifts. They may get a call to respond to an accident 100 miles or 200 miles away ten or 15 minutes before the end of their shift and they cannot say "No" because of who they are and how they have been trained. As has been said, they are advanced paramedics. They are highly trained and highly specialised and they love what they do. They want to treat patients and will never refuse a call but we cannot put so great a moral responsibility on them all of the time that they cannot take breaks or eat properly and that they must sometimes work long shifts for 14 or 15 days without leave because of a lack of capacity in the system.

With respect for the Minister of State and the Minister for Health, who was here for most of the debate, I welcome the fact that additional funding has been put into the National Ambulance Service. Every single cent of additional funding is valued. I certainly value that additional spend. However, I ask the Ministers not to agree not to oppose the motion only to then not implement its recommendations. I do not want to be here again in six months, a year or two years still talking about the same problems. I understand that we cannot solve all of the problems overnight. We need a strategy that is properly funded and that sets out how and when we are going to increase the fleet and the number of personnel. The Minister spoke about training.

I will make one very quick point, if I may. The Minister said in his speech that the national service plan for 2021 set specific targets for response times for life-threatening calls and also for calls with lower acuity. However, he did not say anywhere in his speech whether those targets are being met. The truth is that they are not. That means that patients and those who work in the National Ambulance Service are being failed.

See this speech in context