Peadar Tóibín (Meath West, Aontú) | Oireachtas source

On Saturday, there will be a national day of action against accident and emergency department overcrowding throughout the country. For the first time in the history of the State, hospital campaigns throughout the country will work together and will show up in numbers outside hospitals throughout the State. A total of 15 hospital campaigns will be involved in the national day of action against hospital overcrowding. An incredible feat is being undertaken. There are leaflets and posters, and mobilisation is happening throughout the country. At 1 p.m. on Saturday citizens will gather outside Our Lady's Hospital in Navan, Cork University Hospital, Kerry University Hospital, Galway University Hospital, Mayo General Hospital, Sligo University Hospital, Letterkenny University Hospital, Causeway Hospital in Coleraine, Daisy Hill Hospital in Newry, Monaghan General Hospital, Cavan General Hospital, Regional Hospital Mullingar, Our Lady of Lourdes Hospital in Drogheda, Connolly Hospital Blanchardstown, Naas General Hospital and Wexford General Hospital. The protesters in the mid-west representing Ennis, Nenagh and Limerick will gather at 11 a.m. outside City Hall on Merchant's Quay.

In some areas, thousands of people will protest, in other areas hundreds will gather and in other areas dozens will stand. They will stand united on one main point, which is that some day every one of us will depend on a functioning hospital service being there when we need it. The truth is that this is not the case. It is increasingly not the case throughout the country. The old, the infirm and the sick have been most exposed by the current Government and those that preceded it regarding the lack of treatment. It is a form of cruelty that three of the most vulnerable cohorts in our society can be left so exposed every year in the context of the hospital overcrowding crisis. I thank the hospital campaigns for the work they have put into mobilisation. I urge people throughout the country to come out in numbers to their local hospital. I also urge political parties and Independent Members in the Chamber to make sure that they attend the rallies throughout the country and that they mobilise their members to do so. In many places unions, football clubs and civic society groups are mobilising people to get out on Saturday. It is incredible.

I want to focus on a number of issues. Last year, 120,000 people spent time on trolleys. In many cases, the old and sick were left for an average of 24 hours waiting to see a doctor in an emergency department. Overcrowding in 2021 caused 105,000 adverse incidents. In each of the incidents an individual citizen of this country was damaged by the HSE. This is what constitutes an adverse incident. In a number of cases, people were disabled or died as a result of these accidents or mistreatments.

In the five years up to this year, according to the reply I received to a parliamentary question, the State spent €2 billion on compensating people who have been damaged by our health service. This is incredible. Imagine if that €2 billion was focused on the front-line services in hospitals. Imagine the pain and suffering that would have been alleviated in terms of the families who went through these difficulties in hospitals. It is incredible that such a level of damage is being done. In the main, this damage is happening because staff throughout the country are under tremendous pressure. They are under so much pressure that they cannot do their jobs in as proper a manner as they would wish. One of the Minister's predecessors, Deputy Harris, wrote a report that showed there was a direct correlation between understaffing in hospitals and mortality and morbidity. This is what we have in the State.

All of this has not happened by accident. That is the God's honest truth. Over Christmas, I listened to Government Deputies and Ministers going on radio and television to say this level of overcrowding is happening because of RSV, Covid and flu. Are we really saying the hospital overcrowding crisis is happening because people are getting sick? Are we really saying that if the pesky citizens were not getting sick, the hospitals would be fine? Surely we should be designing a hospital service that has the capacity to deal with the illness that exists in society. This is incredible.

There are a number of reasons the health service is in such bad shape. In reality, it was designed to accommodate approximately 3.5 million people. There are 5.5 million people living in the State. The reason emergency departments are so badly overcrowded is because they have been significantly underfunded. The years of massive underfunding happened just after the banking crash. That underfunding has left our system significantly corroded. We have 6,000 fewer beds than we did in 2008. Even the HSE has admitted that we have 200 fewer ICU beds. We have 30% too few GPs. We are missing 700 consultants. In 15 years, Governments have closed eight emergency departments.

It would be great if the Minister and the Minister of State were not having a chat with each other. We do not get much opportunity to converse and a little bit of listening would be great.

The fact that successive Governments have closed eight emergency departments in 15 years is one of the most frustrating aspects of this process.

I cannot fathom why the HSE cannot draw the dots between an accident and emergency capacity crisis and eight accident and emergency departments just after having being closed. It is surely so obvious. The most frustrating thing is the HSE is still wedded to the objective of closing accident and emergency departments. Even in the middle of accident and emergency capacity crisis, the HSE is actively looking to close the accident and emergency department in Navan. There is a serious dysfunction at the top of the HSE and the Minister knows this better than anybody else. He has had enormous battles with HSE senior management during his tenure. The Department fights with senior HSE staff on a regular basis. By way of a small example of this dysfunction, the HSE forced through an ambulance bypass of Navan accident and emergency department before Christmas. The Minister did his best to fight against it but the HSE managed to get it through. What happens now is that ambulances pick up patients in Meath and bring them to Drogheda, where they are triaged. As Drogheda is not able to deal with them, they are brought back to Navan by ambulance and if no ambulance is available, they are brought back in a taxi accompanied by a medical staff member to make sure they are okay, who then has to get a taxi back to Drogheda. It is absolutely amazing that anybody could have the creativity to design so dysfunctional a system. There has to be reform of HSE senior management in terms of where we are going in this regard. There has to be some level of cohesion between the Department of Health and the HSE if we are ever going to fix this issue.

There are many issues, including a lack of funding for GP care. People cannot get to a doctor for a couple of weeks. Many people cannot get onto a GP list and therefore have no choice but to go to an accident and emergency department. Today, there are approximately 500 people who have been clinically discharged from hospital, which means the doctors have done everything they can for them and they should not be in a hospital bed. They should be at home with a home care package, in a nursing home or on another pathway to another hospital, the national rehabilitation centre or another area of the health service that can help them, but that service is not there. I found out through a response to a parliamentary question that dozens of people are clinically discharged in our hospitals for over six months and that the longest a person was in a hospital while being clinically discharged was two years. Imagine being in a hospital bed for two years knowing the hospital could not help you in any way and that the hospital wanted to move you to another location. How would it feel to be trapped and imprisoned in that situation? It is an incredible thing.

There has to be radical transformation. Money has to go to the front line. If the Minister can do anything, he should consider activity-related funding, whereby hospitals only get paid by the number of operations they carry out, the number of treatments, the number of consultations etc. Then we would not see the money getting snarled up in layers of middle management in the HSE.

See this speech in context