Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

Deputy Cullinane made a point that is worth repeating. The statements by the Minister of State, Deputy Naughton, and the Minister, Deputy Stephen Donnelly, are fundamentally contradictory. The Minister of State indicated that funding "to maintain existing services has been provided to meet inflation and rising patient demand", whereas, according to the Minister, "Some areas are not getting the same level of investment ... as they have [done] ... due primarily to an increase in inflation and patient demand being well in excess of what was forecast last year." Those two fundamentally contradictory statements encapsulate just where we are with this health budget and why there has been so much rancour and righteous anger in the last nine days.

In summing up, the Minister of State, Deputy Naughton, also mentioned that the workers can sometimes be "forgotten in a politically-charged debate".

I mentioned the workers in the drugs sector earlier. Those workers were almost forgotten by this Government earlier this week in the section 39, section 10, and section 56, campaign, when it waited until the very last minute to go to the Workplace Relations Commission, WRC, at 3 a.m. on the day a near historic strike was due to take place in order to come to the table and reach an agreement. This provided much distress for those very workers and of course the service users and their family members who need those services. That is how the Government treats the workers and those who need the health service. The fact that we are here today talking about the damage this budget has done is indicative of just how tired and jaded this Government is and how mismanaged our health service has become. Yesterday again, the Minster, Deputy Donohoe, noted how every Government agency and every Department he engages with at budget time, always makes the case for more funding. That is understandable and we appreciate that. However, it also shows the blatant disregard this Government has to how unique our healthcare service is. It is not like any other Department. A delay in funding for another Department, such as in transport, education, or any other Department, may have a hard impact and may be difficult for communities and for people to take if we are not getting new rail infrastructure or an extra building to a school. They are hardships but nothing suffers as much when it is underfunded than our health service. Our health service is a demand-led service. Nobody turns up at an accident and emergency unit, or a GP service, or gets on a waiting list because they are well. They do it because they are unwell; they are sick. For the Minister, Deputy Donohoe, to lump health in with the other Departments and say that is what every Department does, is totally disingenuous of the needs of our health service.

We heard this week from HSE chief executive Bernard Gloster that harm would certainly be caused by the budget allocation to the HSE. It was a clear and concise message that this Government needs to make sure patients are properly protected. It is not good enough for the Tánaiste to say there is always a commentary on health budgets, as he said today. Has the Tánaiste stopped to think that may be because this commentary, as he calls it, or what we would call politically holding to account, is because of the chronic mishandling we have seen year after year in our health service? Where is the accountability from the heads of Government? The honesty in their approach to heath is absolutely missing. It seems that the Government has given up on health. There is not only a lack of vision in the health budget, but on a more basic level, there is an absence of proper planning. That may be because we have two Ministers, in Deputies Donnelly and Donohoe, who seem to be wrestling for control of the health portfolio. Over the last few days, I have heard from many constituents who have expressed their anger and sadness over the lack of funding for new medicines next year. One such email I received was from a lady who suffers from a chronic heart condition, whose hope of accessing a new drug for treatment has been dashed by this frankly irresponsible health budget. This lady spoke of how her doctor advised her that access to treatment may only be possible by going up to the North of Ireland. That is a complete and utter failing for this Government. We had hoped the days of sending our citizens out of the State to receive basic medical care were long and truly over. Alas, once again, due to the decisions made by this Government, we have managed to somehow see that remain firmly as a choice our patients have to make.

Up to 4,000 people will be affected by this Government's decision not to secure funding for new developments in any of the clinical programmes in the health service and this will create real consequences for patients across a wide variety of areas, including cancer care, diabetes, sepsis, and critical care. The Irish Pharmaceutical Healthcare Association estimates that 1,000 cancer patients will be impacted by the lack of funding. The Minister, Deputy Donohoe, stated this week that spending our budget surplus all at once would be immoral. Will the Minister explain the morality behind denying people suffering from chronic illnesses, who rely on our clinical programmes, the chance to have better health and a better life? The Irish Cancer Society has clearly outlined in recent days that there is a real risk that cancer outcomes could decline in years ahead due to the Government's health budget. The society asked for only €20 million for a cancer strategy. I doubt there is a person in this House who has not had cancer impact on them directly or on someone close to them. How this Government could not find €20 million to invest in a strategy for such an important area that touches everybody's lives is quite frankly beyond me.

Almost 15,000 people contract sepsis in Ireland every year resulting in almost 3,000 deaths. According to the Royal College of Surgeons in Ireland, one report states that sepsis kills more people than heart attacks, and lung, colon and breast cancers combined. In some reports, 60% of all hospital deaths can in some way be related to sepsis. I note the HSE's own sepsis report indicates that 20.3% of deaths in our hospitals are related to sepsis. That is the 2021 figure, up from 19% in 2020. It is a frightening number for what is a frightening illness. This number will not improve with underfunding.

We know from what Bernard Gloster said the other day that he will try to protect access through our accident and emergency departments and will try to continue to bring waiting lists down. It will be difficult to do but if that is where the area of focus is going to be with this constrained budget, it will be our clinical programmes that will be impacted due to underfunding. All the big killers in our country, such as heart disease, sepsis, diabetes, and cancer strategies, are the ones which will be impacted. We have to take a minute to think because we are all guilty - myself included - when we are having health debates of focusing on the day-to-day, week-to-week crises such as trolley numbers, waiting lists, the state of our accident and emergency departments. However, our national clinical programmes dealing with people with the most serious illnesses are the ones that will be impacted according to the chief executive of the HSE and these are the decisions this Government has made. If we take patients affected by diabetes, cystic fibrosis and stroke, a total of 316,000 people impacted by those and related illnesses, have instantly become more vulnerable in the last nine days since this budget was announced. I ask both Ministers, Deputies Donnelly and Donohoe, what they say to the people who have for the last week been panicking about the level of care on which they rely through our national clinical programmes; programmes which aim to improve quality, access and the value of healthcare. One thing we have all said is that the difficulty in our health service is access to the care but once you get in, the care is good if not very good. That is true for many of our national clinical programmes. However, if they are underfunded and a recruitment freeze is implemented on trained non-consultant hospital doctors, on healthcare assistants, and on the absolute bedrock of workers who are needed to require safe staffing, it will impact on these national clinical programmes and on these people who are so sick.

As Bernard Gloster has said, I acknowledge that funding issues have been driven by inflation and unforeseen demand but I have highlighted in the start of my contribution further confusion being laid by two of the three opening statements as regards how the Government is targeting both of those things. I acknowledge the Tánaiste stating today during Leader's Questions that we are now going to set up a forward-looking group to see what the future level of demand will be. This is so the demand will not be unforeseen and that we will be able to see it. However, we have reached 5.1 million people in this country, the highest population level since the 19th century. The fact that this has not been done up until this point, and that this is a knee-jerk emergency reaction to what is an abhorrent health budget, just goes to show again just how tired and jaded this Government is. I will say one more thing. The Minister spoke about community care. We are not seeing that in north County Dublin. We are still served by Beaumont Hospital. In 1986, one year before the founding of Beaumont Hospital, the population of Fingal was 138,000 people. It now stands at 330,000 people. We still do not have minor injury clinics or primary care centres in towns aside from Swords. We still rely on Beaumont Hospital for our acute needs. The community care system is not working there. It is not delivering in my constituency. I had a little bit more to say but I have run out of time and will leave it there.

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