David Cullinane (Waterford, Sinn Fein) | Oireachtas source

Behind all of the facts and numbers that were presented in both the Sinn Féin motion and the countermotion from the Government are real people and their experiences. We heard many of those stories shared by Deputies from right across the political divide. The stories of older people left waiting on hospital trolleys, sometimes for days on end, were shared. Many people do not even make it to a hospital trolley. They are left on chairs in emergency departments for 24 hours and in some cases, for days on end. Some children are waiting for more than 13 hours in emergency departments. People over 75 are waiting longer than people under 75, which is extraordinary. Some people have had procedures cancelled. That is true of outpatient appointments and hospital procedures, some of them cancer procedures. All of this is happening in 21st-century Ireland. Despite all of the boasting put forward by the Government in its countermotion, that is the harsh reality for far too many patients.

Our motion sets out alternatives which the Government should take on board. As another Deputy said earlier, it is like Groundhog Day when we have debates on housing and health because since I was elected to the Dáil in 2016, and long before that, there has been any amount of debate in this House and outside on the need to reform our health service and ensure it is fit for purpose. Here we are with all of those statistics going in the wrong direction and waiting lists for acute hospitals growing. The waiting lists are extraordinary. Approximately 220,000 people are waiting for a diagnostic scan. Over 200,000 more people are on community health waiting lists. Approximately 800,000 people are on acute hospital waiting lists. The mind boggles when you consider the numbers, behind all of which are real people.

We must start by putting the capacity into hospitals. The Minister, Deputy Stephen Donnelly, talks about more beds but there is no urgency around when they will be provided. Promise after promise is made but many hospitals, including the hospitals in the mid-west and Limerick, that have been screaming for more beds for years have not received them. We know we need more beds but we also need more surgical theatre capacity. We have consultants in hospitals who are fighting between themselves for access to precious surgical theatre capacity. That is holding up many medical procedures. There are far too many people waiting for a diagnostic scan because we do not have public capacity.

Of course we need capacity in our acute public hospitals but we also need investment in primary and community care. Anyone who has any understanding of what is happening in emergency departments knows that part of the problem is hospital capacity but another part of it is that we are not providing the right care in the right place at the right time. People who should be cared for in the home are not being cared for because home support packages and intensive home care packages are not available. There are people with chronic pain and chronic conditions who should be managed in the community but that does not happen. Many community intervention teams are not fully staffed. There are people who cannot access out-of-hours GPs. We are not making best use of community pharmacists, particularly out of hours. We do not have enough step-down and recovery beds and we do not have enough rehabilitation options to treat people at home. All of those failures in primary and community care drive more people into emergency departments.

We need to underpin all of that additional investment with a comprehensive strategic workforce plan that once and for all deals with the recruitment and retention crisis in healthcare. The Minister had to acknowledge that he could not deliver the beds and many of the promises he made because staff could not be recruited. Last year, we funded 10,000 additional places for healthcare workers but only 5,500 could be recruited. After years of talking about a recruitment and retention challenge, the Minister stated in his countermotion that "discussions are ongoing between the Department of Health and the Department of Further and Higher Education, Research, Innovation and Science, regarding the expansion of student places across health-related disciplines". God Almighty. For years we have talked about the need to ratchet up training places to ensure a greater pool of graduates coming through and to make sure we have the people to fill children's disability network teams, one third of which still have vacancies. The Minister of State will hear tomorrow about the horrendous waiting times, and the numbers of children involved, for access to those teams right across community care but also in hospitals where we cannot recruit staff. According to the countermotion, there are going to be discussions between the two Ministers. No sense is given of what that means. There is no urgency and no plan. The Ministers are going to have a chat, it seems, rather than coming into this House, which the Minister has not done. I know he is abroad. However, it is standard practice that if a Minister cannot take a motion, he or she would have the manners to contact the proposer of the motion to explain why. Neither the Minister nor any of the Ministers of State were able to make it to the Chamber, which should be noted. That is wrong.

The Minister for Health has not delivered. He has no multi-annual plan and in my view, he is failing patients and those who work on the front line in healthcare.

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