Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

I welcome the opportunity to speak on this legislation. In this House on 9 November, the Taoiseach suggested, in response to comments from Deputy Tóibín about the reconfiguration of Navan hospital, that the Deputy should visit Roscommon University Hospital to see the expansion in the range of services there. I noticed that the Taoiseach said that when I was not present. He might have taken a different approach had I been present. However, having said that, I want to see if the Taoiseach is prepared to live up to his words and I hope that we can see some progress in relation to services. It is true that elective services have improved in Roscommon hospital but ambulance services have not. We also have the scandal that more services could be made available and more people could be treated in Roscommon University Hospital were it not for the deliberate blockage by the Saolta Hospital Group of the provision of the sterilisation facilities that are so urgently required.

I have with me a letter from the then Minister for Health, dated 9 October 2018, regarding the progression of the central sterile services department, CSSD, at Roscommon University Hospital. In fact, a state-of-the-art room in the hospital has been lying idle since 2018 because funding for the equipment has not been provided so that we can fully utilise the two theatres at Roscommon University Hospital. While some parts of the country are struggling in terms of staffing, we actually have the staff to run our theatres but we do not have the sterilisation equipment to ensure that we can maximise the throughput of patients. We have patients from right across the west of Ireland and the middle of this country who are waiting in pain on waiting lists. Some are waiting, sadly, to go to private hospitals, via the National Treatment Purchase Fund, NTPF, to access treatment that could easily be available at Roscommon University Hospital if the funding was provided for sterilisation facilities.

A headline from a local newspaper on 25 October 2018 reads, "New CSSD Unit for hospital confirmed". That was on foot of a commitment I obtained from the then Minister for Health, Deputy Harris, at the time. The newspaper outlined that agreement had been reached between Roscommon University Hospital, HSE Estates and the Saolta Hospital Group to proceed with the unit. The then local Senator, now Aire Stáit at the Department of Health, Deputy Feighan, said at the time, "Based on my discussions with Minister Harris, I am confident this project brief will be progressed to design stage as quickly as possible next year". He went on to say that he had "repeatedly highlighted the need to put a long-term solution in place". Absolutely nothing has happened since then. A brief was prepared and presented to the steering group on 13 November 2019 and there it has sat since.

On 15 September 2020, the Minister for Health, Deputy Donnelly, told me in reply to a parliamentary question that further information was currently being collated in order to future-proof the decontamination requirements of the whole Saolta Hospital Group. That had been going on for 12 months at that stage. The Minister went on to tell me that the HSE had advised him that this exercise would be completed by the fourth quarter of 2020. However, I was told in a recent reply that this is exactly where the project stands today. We have been waiting for three years for the naval gazing to finish because the Saolta Hospital Group and HSE Estates are determined not to fit out a state-of-the-art building. I will tell the Minister of State what is in that building today. The Minister for Health visited Roscommon University Hospital recently to see the new endoscopic facilities there. He passed by the door of the CSSD unit. Inside that unit are walking frames, crutches, beds and wheelchairs because it is now being used as a storage facility. This is a facility that could be used to help to provide treatment to people who are waiting in pain. Instead of that, those people will eventually, through the NTPF, access that treatment in private hospitals. It is just not good enough that for the sake of a small amount of capital funding, we cannot fit out a building that is there already. It is very disappointing.

As the Minister of State will know, I have tabled an amendment for Committee Stage that we will deal with tomorrow. I am not sure if the Minister of State, Deputy Butler, or one of the other Ministers of State in the Department will be taking Committee Stage.

The reason I am questioning the commitment in respect of Roscommon University Hospital is because there is a lack of commitment generally within the health service to our smaller hospitals. The difficulty is that, in the main, consultants do not like travelling. They do not like travelling from the regional centres to the smaller hospitals where there is capacity, where patients can be treated and where we could address some of the monumental backlogs and waiting lists we have. If consultants do not travel, it does not happen. I can give practical examples from what has happened in Roscommon. The Taoiseach is right that the services have increased there and that, thankfully, we have a problem with car parking at the hospital. However, that is because we have had two very progressive consultants who happen to come from County Roscommon, who have dramatically expanded the services there and who provide services that are the envy of any other hospital in the country in the context of urology and plastic surgery. Why is it that we have to rely on our native consultants to provide those services? Why are we not seeing other consultants from within the Saolta Hospital Group providing services? Saolta was the first hospital group established in the country. It had claimed that it was committed to expanding the services and the level 2 hospitals, but that is not happening.

Tomorrow we will see the exact same thing happened with my amendment and health insurance. This will be the fourth year in a row that I will raise the specific issue of smaller hospitals not being covered by Irish Life Health. It has specifically discriminated against the smaller hospitals that could help to ease some of the pressure of the bigger hospitals across the country. To be fair to the previous Minister for Health, Deputy Simon Harris, back in 2019, he did give a commitment to look at the matter. However, the current Minister for Health in a recent reply to a parliamentary question told me that he will not be doing that. I was told that Sláintecare is being implemented, that it is about taking the private health insurers out of public hospitals and that we will use smaller hospitals as guinea pigs in that context. If we want to use guinea pigs, surely it should be the major hospitals that we use because you would start with where there is huge pressure on beds and waiting lists. Of course, that would have an impact on the consultants, the same consultants who will not travel to the smaller hospitals, and they do not want to see their income being impacted in the regional centres. That is why the smaller hospitals are not being protected by the Government in the context of the decision taken by Irish Life Health.

I will make two final points. I echo the comments of colleagues, particularly Deputy Shortall, on Sláintecare. It is imperative that we do drive forward with the reform relating to Sláintecare. However, that does not mean we should use the small hospitals as guinea pigs for it when clearly we are not - as with the example I gave in the context of Roscommon - prepared to put the capital investment in to deal with it. The Minister of State should not come in and spin this yarn to me that the Government is not putting the thumbscrews on Irish Life Health because we want to use the smaller hospitals to drive forward the Sláintecare reforms. If that was the case, the Government would be putting the capital investment into the smaller hospitals but that is not happening.

I want to see Sláintecare come to fruition. We need a single, unified health system. That is why, along with former Deputy Michael Harty, I insisted during the negotiations on the programme for Government in 2016 that there be an all-party committee established to look at this matter and to set down a long-term plan for our health system. That was because I had seen during the previous 15 years I had been in politics that it all depended on the Minister who was it behind the desk on a particular day. As soon as that Minister left, the permanent government would revert to form and the new Minister would come in and would have to start the battle again. It was important, therefore, that there was consistency across Government and political parties. It is imperative that, despite the push-back from the permanent government, we see the Parliament, parliamentarians and politicians taking ownership of Sláintecare and driving it through.

This legislation will reduce the cost of insurance but this will only happen in April when the bulk of people will have already renewed their health insurance. I actively encourage every single person who gets a renewal of their policy to please shop around because there are significant savings to be made. There are a number of companies out there which specialise in that. I actively encourage people to go to those companies, shop around and make those savings, because that will bring about some of the change that is needed.

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