Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I am glad to have an opportunity to speak on this important matter. From dealing with issues relating to health on the health committee for a long period dating back to the health boards, I am deeply conscious of the urgent necessity to respond quickly. I acknowledge the work the Minister of State, Deputy Butler, has done already and the serious burden placed on her in the course of recent years.

The fact is that it was ever thus with the health service. The same issues occur again and again because this is a demand-led service. People do not become ill at a particular time of the day or night or a particular time of the year. They become ill at all times. It is absolutely necessary that the health service is capable of dealing with those situations when and if they arise. We here have all had to deal with the situations that have arisen in our respective constituencies over the years.

I will take a moment to speak about young people. I tabled a parliamentary question a number of years ago on the number of young people who self-harmed and were referred to hospital as a result. I was amazed by the age groups affected, down to as young as ten and nine years of age, an appalling situation. One can only imagine the concern of the parents in dealing with that kind of situation. In many cases there was more than one attempt at self-harm such that it was an ongoing issue. It did not go away. It did not go away with a change in the time of the year or the day or whatever else, nor did the degree to which they were affected. The issue arose again and again.

It is in that regard that we need to respond to the requirements as they arise. Every patient is a part of the experience. Every patient, whether a child, an adolescent or an older person, is a challenge to the system. They need urgent attention, and urgent attention needs to be built around their cases because it is not just one case but several cases, and the one moment of attention given to the one particular patient will resound many times. However, the question about the health service is and always has been how long we wait before we attend to the needs of the particular patient. For instance, I remember not so many years ago a patient being turned out of hospital in the middle of the night, at 4 a.m., with no place for the patient, who slept in a railway station, probably on one of the coldest nights of the year. It is appalling to have to admit to that in this day and age, when we are supposed to be responsive and supposed to have made huge strides - and we have - in respect of medicine in general, whether medicine for physical or mental ill health.

It is obvious that we have to provide for what the need is at a far quicker rate than we have done in the past. In general - and I know that the Minister of State is committed to this - we have to try to do what can be done to address those situations that keep occurring again and again. I know she does that all the time, but the system has to respond. The health service has to respond. The health service has to respond on the basis of the cases presented: how many of them there are, how often the patients have presented, what the nub of the problem is and how quickly we can respond. It should be remembered that there is no sense in responding five years later. That is cold comfort to the people now affected. Five years later a response is of no benefit. It is of benefit eventually, but five years is a long time. If you are waiting on the roadside with a puncture in your car tyre, five years later is no time to respond. I am not for a minute blaming the Minister of State for what is happening; this is endemic in the way the services are delivered.

We also need the patient, whether a child, adolescent or older person, to be able to access a residential place. Very often it is the only thing that can deal with the situation because under supervision something can and should be done and the medical expertise is readily available. The patient knows in the back of his or her mind that he or she is in the right place and is being looked after. The patient's family know in the back of their minds that the patient is in the right place and can be looked after. Consider the situation of there being no place for the patient - very often a very young patient - to go, which has often happened. The parents try always to get hospital accommodation of one kind or another. Even those patients have had to wait a day or a day and a half on a trolley. That does not change the situation. The patient is still in the same condition he or she was in before, and accommodation has to be made on an emergency basis to be able to deal with those kinds of situations when they arise, especially where supervision is required and, in some cases, where suicide watch applies. We cannot cover it up; we have to face it, deal with it, get that residential accommodation as quickly as possible and try to ensure we can deal with the patient and reassure his or her immediate family.

Like every Deputy, I have dealt with cases in the middle of the night where I had to comfort people who were desperate, including families of people who were seeking assistance and crying for help. In some cases, the patient’s family were at their wits’ end and could not understand why, given the advanced society we lived in, it was not possible to resolve their immediate problems. They knew that if the problem was not resolved, there would be consequences.

I do not want to go on for too long and I thank the Acting Chair for facilitating me, but this is an emergency. It was an emergency 20 years ago, and it has not changed since. The population has grown rapidly in the meantime and it will grow even more. There is no sense in saying that, because the population has increased, people have to wait longer. That will not solve the problem. We have to do whatever we must. We have to identify quickly the knots in the system that are delaying delivery and then deliver services as best we can in the shortest time possible.

See this speech in context