Thomas Pringle (Donegal, Independent) | Oireachtas source

It was interesting listening to Government Members before I came into the House and hearing their take on what is happening with the health services. In the same breath we hear that they have got extra money - a record amount of money - and then we hear about all the problems. There should not be any problems because they have this record amount of money. The reality is that the record amount of money is not enough. If the Government and Government Members were to recognise that, we might get somewhere with solving the issue in the first place.

In 2000 there were 3.8 million people in the Twenty-six Counties and today there are over 5 million, which is 1.2 million extra people in need of healthcare and everything else. There are fewer beds in the system today than there were in 2000. How can the system work? It cannot. It is not possible for it to work. Regardless of what needs to be done and whether the system can get working, we will need to carry a lot of extra money at the initial stage to get a system that is working and then we can start to pare back. It is only by getting the system to work in the first place, that we can then start look to make savings.

We hear an awful lot about the need for huge savings because of maladministration. I would love somebody to point out where it is happening and how much could be saved by addressing that. Much as I would like to feel that it would be very easily solved - that getting rid of the administrators would solve the maladministration problem and we would have a load of extra money to deal with issues - unfortunately, I do not think that is there.

One of the Deputies said the Tánaiste said we need a full look at what the HSE is doing. If only he was in government and could actually do that. That would be really powerful. Imagine if we had a government that would do those things. These are coming from the fecking Government Members in the House. It is nonsensical.

Is anyone else listed to speak along with me? I do not think so, which means I have a bit more time than I thought I would have, the Ceann Comhairle will be glad to hear. I will go on a bit more about that.

Our healthcare system is on its knees, and one area that is suffering particularly badly is children's disability services and the CDNTs mentioned by one other Member. I could talk about many areas of the health service that are suffering at the moment. Earlier, I raised the issue of services in Letterkenny University Hospital, as well as elderly services in Donegal. A huge number of areas could be addressed and there would not be time to address them all in today's debate.

There are serious recruitment issues within children’s disability services in my constituency and throughout the country. Children's disability network teams are experiencing very high vacancy and turnover rates. At the beginning of September, the overall national vacancy rate was at 34%. In Donegal the vacancy rate was over 40% in the CDNT areas of Donegal north, Inishowen and Donegal east, and Sligo-south Donegal. There is no doubt that recruitment is a major issue, however, the newly founded special needs parents network in Donegal has stated that employee retention, staff morale, workload and job design are also critical issues that need to be addressed by the HSE.

Despite only being established last month, the new parents network in Donegal has carried out significant research into the experiences of parents of children with disabilities and their findings are very troubling. In a survey of over 300 parents in Inishowen and Donegal east, Donegal north, Donegal south west, Donegal south-Sligo, 87% of respondents stated that their children’s needs were not being met by CDNTs. That is a sad and shocking reflection. I know the CDNTs were supposed to represent the way forward, but like everything else in the health service, they are suffering and getting off to a bad start because they do not have the staff to function properly.

The special needs parents network in Donegal outlined the huge financial burden from the lack of service provision from the CDNTs, with parents, especially parents of children with complex disabilities, feeling they have no option but to access private treatment. It is absolutely essential that children get the therapy they need, as those who do not can experience significant regression and pain. No parent or child should be forced to experience this.

However, we are forcing them into this situation because the HSE will not allocate funding for children availing of private services. This means that services are only available to those who can afford it, which is very unfair on disabled people. The HSE, recognising that it cannot get the staff to get the CDNTs working, should support families in sourcing private solutions.

I know that is not, and should not be, the solution, given the replacement of public services by private services should never be the solution, but something has to happen in the meantime because children are being left behind and failed. If children are unable to avail of public services, they have to be facilitated in availing of private services. Services for children with disabilities, especially complex disabilities, are not optional. Some 86% of parents in Donegal feel that support to access private therapy would be helpful to them, and families in the region have reported paying up to €400 a month on private therapy. Such services should not be available only to those who can afford them. Even those families paying that amount cannot afford it because they lose out on other stuff, but they are forced into that situation because they have to help their children. That is completely unacceptable and raises serious questions of inequality. It is in direct contradiction to the United Nations Convention on the Rights of Persons with Disabilities, which was created to ensure the full and equal enjoyment of all human rights and fundamental freedoms by all disabled persons.

Addressing issues of recruitment will, as I mentioned earlier, require thinking outside the box. What we are doing clearly is not working, and a better way needs to be found. One of the ways these issues could be addressed is by ensuring that graduate doctors in the North of Ireland are facilitated in registering in the South. That is a massive obstacle for northern graduates and forces many overseas. The reality is that, because of a timing issue, graduates from the North cannot complete their training in the South. Basically, their results do not come out on time for registration in the South, which is shocking. It means that they all go over to England to complete their training and then are lost to us and the Irish system.

In addition, 83% of parents in Donegal felt that it would be helpful to extend the cross-Border health initiative to incorporate disability services. For counties such as Donegal and those along the Border, that would make a difference and would not require much thinking on behalf of the HSE. It would make the cross-Border initiative available to those parents in order that they could in many instances get services based in Derry, Enniskillen or somewhere like that and that their children could benefit from them. Again, that could be done as a temporary solution. It is a solution that would last only a short period, one would hope, in order that recruitment could take place.

The solutions are there but the Government is failing to implement them and, in turn, failing disabled people in this country. The HSE is trying to recruit locally rather than relying on national recruitment and is trying additional stuff all the time, including advertising on Facebook and so on, to ensure that this can go ahead. It should, however, be able to do that across the board. That might go some way towards alleviating some of the problems. It could ignore the national recruitment processes and work on local recruitment, trying to identify people who could come forward as healthcare services staff right across the board.

The families of children who have additional needs and who are working on the CDNTs were putting forward solutions and want solutions. They got the solutions from the health service and suggestions as to what could be done. Another meeting is coming up in six to eight weeks or so, when actual progress will be shown as to what is happening. I hope that progress will be made there because that will be vital. Perhaps that should be a model in showing how things could work across the country, whereby the people are working together with the families that need the services but they are also accountable in allowing themselves to come forward and come back to another meeting to show whether or not they are making progress and what is going on.

There is no doubt that we could talk in this debate about other services in the HSE that are also suffering from a lack of funding and service difficulties. One of the main issues is the recruitment and the retention of staff. That is the reality and that needs to be sorted out. That needs to be done across the board. If that could be resolved, we could go a long way towards looking after our health service. The reality, however, is that the budget that has been allocated for next year will not solve that problem because a recruitment embargo is ongoing in the HSE. How will the HSE recruit staff during a recruitment embargo? The Minister might address that in his summing up, but that is the reality and, therefore, Government Members need to come to terms with that. There may be a record budget allocated for the health services and the HSE but it is a record that will be broken because it has to be broken and because we need more money and more staff to make things happen and to make things work properly. The Government needs to come to terms with that and make things happen.

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