Dáil debates

Wednesday, 28 September 2022

Financial Resolutions 2022 - Financial Resolution No. 6: General: Financial Resolution (Resumed)


4:15 pm

Photo of David CullinaneDavid Cullinane (Waterford, Sinn Fein) | Oireachtas source

Before this budget and for many years now, we have had a crisis in healthcare. Year in and year out, winter after winter, the health service is in crisis management mode. After this budget the health service will, unfortunately, still be in crisis. Waiting lists will continue to spiral out of control. There are now more than 910,000 people on hospital waiting lists and a backlog of more than 225,000 people waiting for a diagnostic scan. Children with disabilities cannot get access to vital therapies. People with mental health challenges are abandoned to struggle in silence. Home help hours cannot be filled, leaving older people unsupported and uncared for. Almost 1,000 consultant posts are either vacant or filled on temporary contracts. Even private GP services are stretched thin. Out-of-hours services are collapsing, which is heaping more pressure on overcrowded emergency departments where the average wait is now over half a day. Over the course of the past two years, we have seen the dental treatment service scheme collapse, with dentists leaving at a rate of knots.

More than five years on from publication of the Sláintecare report, the Government has yet to agree a new public only consultant contract, to resolve long-standing disputes with workers from junior doctors to medical scientists or to put in the capacity to create an equitable universal health service. This budget, unfortunately, will be cold comfort for the 100,000 children languishing on hospital waiting lists. There are 20,000 children with disabilities who are still waiting for initial contact with a disability network team, never mind the follow-up therapies and interventions. I have travelled the State over the past number of months and have met many parents of children with disabilities. It is one of the most heartbreaking things have to do, to listen to parents of children with disabilities talk about the love they have for their child and how they are doing everything they can to fight the system and to battle the system. Yet, their children go without the supports and services they need. We have so many posts funded and yet we cannot build them. As I said to the head of the HSE today at the Oireachtas Joint Committee on Health, I do not see a plan that is going to solve those problems and I do not see anything of substance in the budget from the Minister of State, apart from more outsourcing.

Children with scoliosis and spina bifida are continuously being told that they are a priority and that they would get their surgeries, but time and again they are let down and failed by a creaking health service. Additional funding was made available last year to carry out more surgeries for children with spina bifida and scoliosis, and I welcome that. We saw improvements in the wait times at Cappagh hospital. We saw, however, a regression of wait times in the other two children's hospitals. I do not believe that this is acceptable and I do not believe there is anything in this budget that will tackle this problem.

This year's budget is yet more proof that the Government does not have a plan for the health service. The Government does not have a real plan for waiting lists, for free GP care, or for removing private healthcare from public hospitals. In fact, the Government has not even started that process, which is a key part of Sláintecare. It is clear that the Government does not have a plan to address the major workforce challenges facing the health service to train, recruit and retain enough healthcare workers to deliver additional capacity and to make real change.

This year my party leader was in Australia, Canada, and the United States and met many healthcare workers.

Some leave because they want to develop skills. They might want to leave for a couple of years and some will come home. Many, however, said they left because of our creaking health service, because they did not feel valued and because of a range of recruitment and retention issues where promises had been made time and again by successive Ministers for Health that had not been delivered. We should be moving heaven and Earth to get as many of those people as possible back working in our public system and delivering the health services people need. That will require a step change in workforce planning that I do not see from the Minister or his Government.

This budget was an opportunity for a different approach but it has been squandered. Despite the best will and talent in the health service, it is in perpetual crisis because of the severe lack of capacity. Still the Government has not included a single red cent for additional acute inpatient hospital beds next year. Beds which were funded in previous budgets will be delivered but there is no new funding for new beds in any of the measures that I can see. Instead, despite the big promises and big announcement the budget represents more of the same: a continuation of outsourcing and crisis management. The amount of money that the Government is spending on outsourcing through the National Treatment Purchase Fund and outsourcing diagnostic capacity is staggering compared with the €250 million of new measures contained in this budget which do not go anywhere near enough to what is required to deal with the crisis in our hospitals. Less than one-tenth of 1% of an increase in acute services, or €4 million, that is the increase in new measures in the budget. There are people on hospital trolleys and languishing on waiting lists. The Minister only needs to read his own budget. I have. It is €4 million in additional new measures in acute services at a time when we have record numbers of people on hospital trolleys. For me, that is unacceptable.

Making big promises and throwing out big numbers is not a plan or budget. Two years ago the Minister announced 1,100 additional beds. Some of those are still not delivered. Last year he announced 10,000 staff and only half were delivered. Now he has announced 340,000 more people will get access to free GP care. I welcome that but there is no plan on how to deliver it. The Minister has not put the capacity in and without that, it will fall flat on its face.


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