Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

I welcome the removal of the acute public in-patient charge. This is a very positive move. I will be supporting the Bill. I also welcome the public contract for consultants. I congratulate the Minister on that; it is a big step.

The Bill gives us a chance to reflect on the mess our healthcare system has become over the past few decades. More than two decades ago, when the Tánaiste was Minister for Health, a bed capacity report showed that we needed 5,000 extra beds in our health services by 2011. These are nowhere to be seen. In 2022, we had 7,000 fewer beds than we did in 1981. The Government likes to publish reports and plans on increasing bed capacity, but on "Morning Ireland" last week, Dr. Mick Molloy of the Irish Medical Organisation stated that he could not see any extra beds in the system. The Irish Nurses and Midwives Organisation recently indicated that there were 10,040 patients on trolleys in February. Dr. Molloy also stated on "Morning Ireland" that these massive numbers of people on trolleys are no longer surges; they are the new normal. He also said there was very little we can do in respect of the current crisis without a dramatic increase in the number beds. He identified increasing the number of accident and emergency and acute beds as a priority in the context of investment.

Our accident and emergency departments are over-strained. They do not have enough staff and they do not have enough beds. Accident and emergency departments are at the centre of all the failings in our health service. The number of GPs is declining and people are having difficulty getting GP visits. This is pushing people into accident and emergency departments. Years-long waiting lists for surgery and treatment push people into accident and emergency departments. Failures in our care homes and the care system push people into accident and emergency departments. Yet, I can see no evidence of the Government making the investment that is needed to combat this.

The other matter Dr. Molloy highlighted is the need for a dramatic increase in the number of elective surgery beds. He used the phrase "at minimum" regarding our acute bed capacity. The ESRI estimates that we need between 4,000 and 6,300 acute beds. We need those in at least three new acute hospitals.

Successive Governments have been happy to allow a two-tiered system in which those who can afford private medical care get treatment and everybody else who is accessing public healthcare is on a waiting list to remain in place. I tabled a parliamentary question on behalf of a neighbour of mine who has been waiting for an operation on an incisional hernia, which was detected at St. James's Hospital in December 2018.

She is a recovering cancer patient and is under the care of one of the professionals in St. James's Hospital. She received contact from the waiting list co-ordinator in December 2019 to say that she had secured funding to have her operation at the Beacon Hospital in six weeks' time. I presume that was from the National Treatment Purchase Fund, NTPF. She heard nothing back. I put a parliamentary question in on this in 2021 and I got a reply in August to say that the patient was on the waiting list, that Covid-19 had impacted on scheduled care and that she would be brought in as soon as possible. I had not seen her for a good while but I met her yesterday and she is still waiting, from 2018 until now, for that operation.

It is clear to everyone that the Government parties, over successive Governments, have not done nearly enough to increase the bed capacity in the public health service. Large hospitals are supposed to operate at 85% capacity, medium-sized hospitals are supposed to operate at 75% capacity and we are now seeing Irish hospitals operating at 110%, 120% and 130% capacity while thousands wait on trolleys. This is just not safe. We know that the lack of timely access to healthcare in this country will be responsible for over 300 unnecessary deaths per year and we know that staff and bed shortages are causing unsafe situations in our hospitals for both patients and staff. Twice this month the INMO has had to ballot members over the unsafe staffing situation in hospitals up and down the country. It has called for a national response to the massive overcrowding crisis we are in the middle of.

We seem to see this time and again. The Government pushes new reports, plans and accolades about the successes but everything just gets worse. We are seeing record homelessness and record numbers of patients on trolleys, as well as staff shortages in hospitals, mental health services, social workers and housing services. The Government should start building the houses and hospitals and it should start providing the services and numbers that everyone is saying we need now.

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