Matt Shanahan (Waterford, Independent) | Oireachtas source

I do not want to come into this Chamber and suggest that our health service provision is a mess, but clearly some things are not working and need to be changed. I acknowledge the many people in the service who are doing extraordinary work. I also commend the ongoing development of our community and primary health sectors. These are fundamental to relieving pressure on our acute hospital systems. On community sector developments, I congratulate all those in my local area, CHO 5, on the work they do. I acknowledge the work done by the Minister of State, Deputy Butler, in the area of mental health services and older people. I acknowledge the announcement made by the Minister this morning of a new neurology team for CHO 5. It is very welcome. It is also important to acknowledge the Government's engagement with section 39 health workers, and the Minister of State's work on children's referral, in particular to CAMHS, and the No Wrong Door strategy. These are all to be welcomed.

On the drug strategy the Minister of State, Deputy Naughton, spoke about, I point out the important work done in the area of addiction. I highlight Gerry Carroll and Aiséirí in Waterford who do terrific work. There are, however, significant funding problems for organisations like this. I ask the Minister of State, as part of her budget, to provide funding for therapy services, addiction therapy counselling in particular.

The health debate can be divided into a number of major areas but it boils down to a number of issues. Those are cost versus efficiency, service planning and recruitment, training and retention of staff, capital delivery and the future-proofing and embedding of technology in our service practices. What is not measured cannot be managed, as we have seen. Unfortunately, a large number of our problems in budgeting are because we are not properly monitoring or looking at the best in class and trying to get others to emulate what they are doing. That is what would be done in private business but that seems to be anathema to the public service. We have stellar exemplars and we let them do what they do. The Ministers know what work has been done in University Hospital Waterford on emergency department management, in particular when the Wexford emergency department was closed. How were all those patients managed? How were the acute beds managed? Why did we not have patients on trolleys during all that time in the model 4 hospital with the lowest level of funding in the country and the smallest number of healthcare staff? Nobody has looked at that case and asked why it happened.

I have written to the senior Minister on an issue I raised recently concerning the number of interns at Beaumont Hospital versus UHW. There are 92 in Beaumont and only 25 in UHW, despite UHW having a higher rate of outpatient procedures. The question was "Why?" When I wrote to the Minister what I got back was that it was basically the colleges who provide medical education and look after placement. This has to be sorted out. A budget has not yet been provided to open the second cath lab seven days per week. The commitment is there to do that by Christmas. I understand that, despite moneys being promised by the HSE to support the activities of UHW during the Wexford emergency department closure, nothing extra has been given to the budget of UHW.

The diabetes unit in Waterford has no insulin pump therapy or adult insulin pump programme. It is the only model 4 in the country without that. I ask the Ministers of State to look at that.

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