Brendan Howlin (Wexford, Labour) | Oireachtas source

This is a simple but a very important measure to abolish the inpatient charge for adult public patients in public hospitals. The Bill, as the Minister has indicated, repeals section 53C of the Health Act 1970 so this is a thing that has lasted a very long time, together with the associated regulations. This is all very welcome and will certainly assist in the cost-of-living pressures that so many people are acutely feeling right now. The notion that people would be inhibited from even going to a hospital because of a charge makes it right that this charge should be abolished if we are in a position to do so. It should be abolished.

The abolition of inpatient charges is of value only if one can access inpatient services. Too many of our citizens are on long waiting lists to be diagnosed, in the first instance, for their treatment. Then, finally, having been diagnosed and having seen a consultant, they are again on ever-longer waiting lists to receive treatment.

The general story one hears from people is that once they get in to access the health service, it is an excellent service.

The problem is getting in in a timely fashion. Certain illnesses are often compounded by the wait.

There are, as we know, insufficient hospital beds and insufficient staff to serve those beds. Thankfully, we have an ever-increasing population and are living longer. We know all this and we also know some of the strategies needed to address these enduring, ever-recurring deficiencies. There has been all-party support for a new strategy, Sláintecare, and to implement that we need, among other things, more hospital beds, a single-tier acute hospital system and no more experimentation with issues such as co-location, which has in the past distracted us from doing what was really needed. We need a functioning primary care facility to be available to all. I acknowledge all these things are happening. Primary care centres are being built, and more and more services are being delivered through them. That is the sort of ongoing pressure we need to see delivered. We have a political consensus, at least regarding the direction, such that a change of government no longer means an entire change of direction in healthcare, and that is important.

Support for GPs is critical in all this. This is one area where we have not addressed a looming crisis. In my constituency, Wexford, I have talked to dozens of GPs. Rural, single-handed practices, in particular, cannot get locums to cover them and allow them to attend important events, whether tragedies such as funerals, celebrations such as weddings or family occasions such as communions, while those who are coming to an age of retirement cannot get replacements. It is clear that throughout rural Ireland, in particular, we will not have the pattern of GP coverage that we currently have into the future. More and more multi-GP practices are operating out of towns, and people in large rural areas are no longer covered by a GP, which has always been an essential part of health provision here. The fundamental issue of resourcing GPs, training more GPs and getting more doctors to opt for general practice as opposed to the automatic stream must be very high on the Minister's agenda. An acceptable consultants' contract will now, I hope, be implemented. I again commend the Minister on finishing the negotiations but it is important that it be rolled out and effected and that we will have, for the first time, an understandable, single contract for consultants that will provide the sort of public cover we have all sought for a long time.

We also need the appropriate range of specialists to ensure all the needs of recovering patients will be met. All of us Deputies come across every day in our clinics and offices people who have been treated but need physiotherapy, speech and language therapy, occupational therapy and all the other ancillary supports, but they are just not available and that is hampering their recovery, and in some instances, pushing them backwards.

The importance of an acute hospital for a population base is critical and that is only fully realised, as the Minister knows, when it is threatened. Wexford General Hospital, my local general hospital, faced that threat not through any political action or staff action but through an unprecedented fire that happened there on 1 March and shocked us all. The immediate response, as I indicated to this House the following day, was nothing short of amazing. The HSE staff, the firefighters, the voluntary organisations, the local community, the National Ambulance Service and so many others - everybody who was asked - rallied and the response was amazing in that all 200-plus patients in the hospital, including people who were critically ill and two women who were in the process of giving birth, were evacuated safely. I should say, the two women stayed and delivered. I can imagine the conversation the nurses had, saying, "We are grand. The place is on fire but carry on." It is magnificent that nobody was injured in all that, and 100 ambulances arrived to remove people.

All that is magnificent, and all that effort is absolutely to be praised and lauded, but the question now is what is next. The Minister and the Taoiseach have visited the hospital and, I am glad to say, have put a number of clear commitments on the public record. We were briefed at the end of last week on what is happening. Obstetrics and midwifery is back open and fully operational. The patients who were removed have, by and large, been returned and are back in the hospital. The medical assessment unit has opened, as has a minor injuries unit on an 8 a.m. to 8 p.m. basis and to move shortly, I hope, to a seven-day basis as well. The outpatient clinics for endoscopies and other procedures are all operational, and we are using Ely Hospital as a support base for services. In combination, there has been a magnificent effort.

The big question that remains, however, relates to the return of accident and emergency services. Unfortunately, that concern has not been addressed, and we need to know when that will happen. I have been told it could be up to six months, which would really put pressure on the adjoining hospitals as well as being a big burden for the people of Wexford to carry. I ask the Minister, therefore, to look again urgently at ensuring the accident and emergency services will reopen at the earliest possible date. That is the will of both the people of Wexford and the staff of Wexford General Hospital.

The Minister will not be surprised at me making my final point, which concerns the building of the 97-bed unit. It was to comprise 96 beds but one of the treatment rooms has been changed to a 97th bed. It is an essential part of the next phase of the hospital. A month ago, the Minister told us he was awaiting an assessment report, but he has been more positive in his utterances since. Both he and the Taoiseach have raised the issue of planning permission as one of the possible impediments to getting it done. I ask the Minister, on the record of the House, to use his powers. I have talked to the planners about this. Section 181(2)(a) of the Planning and Development Act 2000 gives powers to the Minister for Health where it states, “Where development is proposed to be carried out ... the Minister of the Government concerned ... if he or she is satisfied that the carrying out of the development is required by reason of an accident or emergency, by order provide that this Act or, as may be appropriate, any requirement or requirements of regulations ... shall not apply to the development". Effectively, that means the Minister can construct the new 97-bed unit and restore the building in respect of the damage done by order under the planning Acts without planning permission. Will he look at that and avail of those powers, which are designed to meet an emergency situation such as this? He will have not only the full support of the people of Wexford but also their gratitude if that can be done, and I ask him to do it.

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