Joe Flaherty (Longford-Westmeath, Fianna Fail) | Oireachtas source

In discussing health and the health budget 2024, it is important we stand back from the media spin and the claims of the Opposition. Spin has never cured a patient and will not aid any recovery. The reality is we have seen unprecedented investment in health. The budget for 2024 will be €22 billion, up 80% on the €13.2 billion in 2015. It is an extraordinary increase by any reckoning and indicative of this Government’s determination to get to grips with the many challenges facing health. I hypothesise that if we had given the additional €2 billion to health, the same Opposition would clamour and claim we are simply throwing taxpayers’ money at the problem.

Throughout the Covid era we dedicated enormous resources and money to addressing the structural issues in our healthcare system. I have listened to the Tánaiste speak on the issue a number of times since the budget. He is a former Minister for Health and probably better understands the workings and failings of the system, and specifically the HSE, than anybody else in this House. He correctly pointed out we need a deeper analysis of how we spend money in health in the context of analysing demographics and taking account of fuel and food inflation. I have also heard several health economists in recent days speak on this issue. They see a balance in the argument. They see the Government’s position but also see the challenges facing the health sector.

Much has been made of claims the HSE will not be able to recruit in 2024 but the reality is throughout recent years, when the system was awash with money and record investment by the Government, the HSE still could not recruit to fill home care roles and disability sector posts because of inherent flaws in its processes. Giving it the money will not address those issues but will further line the pockets of agencies which are creaming the health service at the moment.

Every Member of this House has listened for hours to families struggling to get therapies for children and desperately trying to get home care for their parents. We feel for staff on the front line trying to deal with these beleaguered parents and families daily. These staff have pointed to the issues and shortcomings and have lamented the inability and unwillingness of senior management to address these glaring inadequacies. It is time to challenge the HSE. The Government should not and will not allow the health system to suffer. Equally, it should not fling money at a sector racked by shortcomings and inefficiencies. It is time for the HSE to step up, work with the Government and finally deliver a world-class healthcare system befitting a €22.5 billion budget.

We need to start seeing accountability. If we, as in the past, allocate €20 million for the treatment of scoliosis, it needs to be spent on just that and alleviating the pain and discomfort for so many young people. If we provide funding for an additional 200 therapists in the disability sector, we need to see those roles appointed. If we provide funding for additional home care staff, these people need to be appointed on HSE terms and conditions, not outsourced from agencies where profit is king and patients are ancillary.

What is not and has not been acceptable is the failure of the HSE to follow through on this Government's actions rather than appointing more administrators and outsourcing agency staff at enormous cost to the HSE, the State and, consequently, taxpayers.

If funding is the challenge in 2024 for the health service, this Government will not be found wanting. Equally, it is time for the HSE to embrace the concept of accountability and to play its part in delivering the service we expect and people would and should expect from a €22.5 billion allocation.

I want to acknowledge the role of Bernard Gloster. The Opposition has made much of him addressing the threat of an overrun in 2024 in a weekend interview. We need the head of our health service to be a strong voice for the service. We need to hear his views and concerns. The Government will work with him for the betterment of the service and the well-being of patients.

I want to address a couple of specific points. I commend the Minister of State, Deputy Rabbitte, in particular, and her colleagues in the Department of Health on the progress we made on section 39 pay in recent days. We still have a fundamental problem with section 39 organisations. They are out of kilter with their colleagues and contemporaries in the HSE and other sister organisations throughout the country. It is something I would like to see grappled with within the lifetime of the Government. Notwithstanding the recent pay increases that have been agreed in the order of 8%, they will still be some way off their colleagues in HSE posts. I refer specifically to the staff of St. Christopher's Services, Longford, who are still due back pay in terms of increments and the €1,000 pandemic bonus which was not paid to them even though they worked throughout pandemic. That is disappointing. It is a significant sum of money for a lot of people and something they had planned to use for children going to college or to do something around the house. It is important that this be addressed and I would like to see it addressed. It is embarrassing at this point as a Government Member that I have to come, three and a half years into the life cycle of the Government, and speak to something that I consider as minor. By the same token, however, something as important as that should have been resolved.

While I am on the pandemic bonus, I also want to address the issue of registry offices in CHO 8. It was the only CHO in the country where staff in the registry office did not get the pandemic bonus. It speaks to the folly of the HSE that those staff are taking a case to the WRC, which will result in additional expense for the HSE. I ask that the Minister contact CHO 8, and tell it to stop this folly and pay the €1,000 due to the handful of people there. It is quite ridiculous. If this happened in the private sector, someone would be answerable and held to account.

Last week I mentioned a nurse in St. Christopher's Special School, Longford. There is a bizarre situation whereby a school with 14 children with complex and advanced medical needs, many of whom are PEG fed and require hoists to be lifted in and out of school, only has a nurse on site for 14 hours a week. The school could not keep a nurse; the last one was appointed only in March and left in recent weeks. The school has made the business case for a nurse to be appointed for 32 hours per week and interviews for the post concluded yesterday. I understand the school will recommend an appointment to the HSE. I hope to see that appointment followed through on and that a nurse will be in situin the school as soon as possible. It is a crisis situation and there is a real risk that children and parents have to be notified that the school cannot accept children.

In the time I have left I want to raise a case with the Minister of State, Deputy Butler, who has been very supportive of me. The case involves a young boy and family with whom I am familiar. The boy is currently in a general hospital and has complex care needs, including autism, mental health issues, bulimia and anorexia. He is at a crisis point at 13 years of age. His family are at their wits' end. In fairness, the team from Linn Dara visited the general hospital this day last week and assessed him. The hope and expectation was that we would get the young boy to Linn Dara as soon as possible. We have heard many people in the House address issues with CAMHS during this debate. Over the past week, I have lived that experience to some extent. The boy's aunts and older sister have phoned me. I am extremely fortunate to be in a position whereby I am not living this experience directly, but I feel their pain and empathise with them. It has to be frustrating for them to know there is a facility that can deliver care and give this young man a fighting chance. We all remember when we were 13 years of age and had the best of ambitions and the greatest of plans for life. To see a young boy in a general hospital with security guards on his door and the hospital having no recourse other than to try to force-feed him when 80 miles up the road, there is a facility that can deliver the state-of-the-art car he needs is difficult. The Minister of State is aware of the case and has engaged with me and been hugely supportive of the family. It is very much a plea from the heart. I am in a privileged position to be able to make this plea on behalf of the young boy and parents, aunts, siblings and extended family. I appeal to the Minister of State to ensure we get him to Linn Dara without delay.

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