David Cullinane (Waterford, Sinn Fein) | Oireachtas source

The speeches this evening from both the Minister, Deputy Donnelly, and the Minister of State, Deputy Butler, were breathtaking. In response to an emergency in our hospitals, the Minister's biggest complaint was that Sinn Féin did not give him a pat on the back for the good work he believes he has done. That was his chief complaint, repeated time and again in his script. The Minister of State, Deputy Butler, was concerned that we were too robust in our criticism of Ministers past and present. In fact, we were not robust enough because successive Governments are directly responsible for failing to properly equip our health service. What was absent from both of their contributions - I asked for it but it did not come - was any responsibility whatsoever for what has happened. There was no responsibility for patients on trolleys in record numbers, no responsibility for people lying on floors in emergency departments, no responsibility for older people over 75 waiting days on end in hospitals for care and not getting it, no responsibility for the fact that people could not access out-of-hours GP care. They took no responsibility for the fact that front-line healthcare staff are telling me every day of the week, and I am sure they are telling the Ministers as well, that they are broken. They are working huge amounts of overtime. In fact, the situation in our hospitals would be a lot worse today if not for the escalation emergency measures that were taken and people being asked to do more work on the front line, doing overtime that is actually dangerous. There has been no acknowledgment from the Minister or Minister of State.

Not only was there no responsibility, there was no apology from the Minister for Health. At least the head of the HSE had the gumption to apologise for what happened. This Minister was concerned that we in Sinn Féin did not give him a pat on the back, never mind giving an apology. Let me remind the Minister again of what I said earlier. Yes, there are things he has done that I recognise as important. Things have been delivered that will make a difference. I welcome any additional resource in healthcare. I have said to him for a long time what needs to be done to fix problems in our emergency departments. All the commitments that were given to end the trolley crisis and deal with waiting lists were promises and commitments the Minister made. I am holding him to account for promises he and successive Governments have made. They are the ones that said they were going to fix the problem but year on year, month on month and day on day, the situation gets worse.

There are four things we need to do. First is to start with the hospitals. We know we need more beds, more staff, more consultants, doctors, nurses and so on. We need more diagnostic capacity. More GP access to diagnostics is welcome but we need more capacity in the hospitals to ensure we can speed up patient flow in hospitals The lack of capacity is slowing things down. We need elective-only hospitals delivered as quickly as possible to separate scheduled and unscheduled care as much as we can. We need to double capacity in the National Ambulance Service and we need to make greater use of level 2 hospitals and of private hospitals for the public good. We need to do all of that and more.

The second thing we need to do is once and for all take workforce planning seriously. The Minister said in his opening statement that we need to double training capacity. He keeps saying it but he is not doing it. We are nowhere near it. In fact, the Secretary General of the Department, when he was before the Joint Committee on Health, acknowledged that what needs to be done in terms of workforce planning is not being done. The Minister should stop telling us what needs to be done as if he is some objective commentator. He is the Minister for Health. He should put in place the measures to substantially increase training capacity and a proper workforce plan once and for all. If we do not have the workforce plan we cannot train, we cannot recruit and we cannot retain the healthcare professionals we need to open the beds, provide the diagnostic equipment and provide all the care in the community. We need the right care in the right place at the right time. The Minister of State, Deputy Butler, talked about all the community intervention supports and supports for older people. Lots of those teams are not properly staffed. We do not have enough GPs. We are not making use of community pharmacies. There is a huge amount we need to do in terms of community care. I do not have time to go through it all. That is the third priority.

The fourth is reform. The Minister said this himself and it is one of the things I agree with. We need better management. That is a fact. In some hospitals there should be better management. I do not agree with what was said by some Deputies in the Chamber around singling out any individual managers but I believe we need best practice across all hospitals. The responsibility for driving that change and making sure managers and hospitals are actually given the resources to do the job lies with the Minister. After everything that happened, after everything all of those on the front line have gone through and all the suffering of patients, there is no responsibility, no apology, no leadership and no vision from the Minister and his Government colleagues. That is shameful.

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