Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I have watched it on screen. I say this in the context of a debate of this nature when many of us, including the Minister, are trying to be serious about this very concerning budget. At a meeting of the Joint Committee on Health earlier, we heard from Bernard Gloster, CEO of the HSE, and Robert Watt, the Secretary General of the Department of Health. While both were coming at it from slightly different angles, they told the same story, which is what we have known for more than two weeks and which was brought into sharp focus with the landmark interview Mr. Gloster did on the Sunday before last when he said that the health service is underfunded.

The Minister, as he did earlier and as is done in the countermotion, can list off elements of the health service that are being funded. We can contest this and we can contest that. We can go around the houses. We can debate for hours, but these are the uncontested figures, namely, the €1.5 billion deficit by the end of the year and a further deficit of €1.2 billion. We are in a more acute space with this health crisis than we have ever been in before.

We cannot be surprised that people want to leave the system. This Government has let workers down. The recruitment freeze that was announced will impact not just on the grades that are the subject of it. We are aware that our staff work as part of a team and as part of a chain. As a result, if we do not have healthcare systems and if we do not hire enough non-consultant hospital doctors, it will impact on nurses, on other healthcare assistants, on consultants, and on all aspects of our health service. There is no getting around that. No amount of debate we have had either in this House, in the committee or on the airwaves has got away from the fact that as a result of this budget harm will be caused.

As it currently stands there almost 900,000 people on waiting lists. Today, 559 people are lying on trolleys in our hospitals. Again, this is another day of normalised crisis in the way in which we refer to our trolley count. It is incredible we do not even blink an eye at the figure of 559 in our trolley crisis and that it does not even make the news on any particular day. Yesterday, 130 patients were waiting on trolleys in University Hospital Limerick. It was another record-breaking day for that hospital. That is absolutely outrageous. It is in this context that Bernard Gloster said he will do his best to protect, namely: access to accident and emergency departments; ensuring they are adequately funded; and keeping the waiting lists down. If the health service is underfunded to stand still, if these areas of our health service - access and waiting lists or acute services - are the ones that are not being protected as matters stands and if Bernard Gloster is going to have to direct more of his funds there, then we really are facing a very concerning 2024.

Regarding last week, the whole approach to health and this charge we are putting across, there is a feeling that this Government has thrown in the towel. The crisis has just gotten too big and inflation, unforeseen demand and the cost of running our healthcare system, seen as a triple reasoning, have just beaten this Government. Health is different. It is different from any other Department. It is demand led. We are all supportive and want to see savings made where they can be. We want to see a more accountable HSE. We want to see it being better run. We also know that there are 5.1 million people in the country. People are presenting to accident and emergency departments, to their GP services and to their primary care centres because they are unwell and sick and because they need care. This Government and this health budget have left many people in the country afraid of presenting to their health service. The national strategies, which Bernard Gloster says he will be unable to protect given the funding allocation for next year, are going to be starved of funding because the budget just will not be there. By not providing adequate funding, these strategies will not simply stand still; they will actually go backwards.

I will reiterate the point I have made a number of times over the past two weeks: the response the Minister for Public Expenditure, National Development Plan Delivery and Reform gave about re-examining the health budget clearly is not sinking in. We have to re-examine it, as this motion calls for. We have to re-examine it urgently. We cannot go down to the wire in December for an emergency supplementary budget. That is not good practice. It is not going to do us any good going into 2024 if we have another year of budgetary crisis. This Government has no problem going last-minute on health. We saw it last week with the section 39 dispute when negotiations went until 3 a.m. on the morning of what would have been a historic strike in our care sector. This Government is not afraid to wind the clock down, much to the concern of vulnerable and sick people all over the country.

At least 4,000 people will be impacted by the Government's decision not to secure funding for new developments in any of the clinical programmes in the health service. That is going to mean real consequences for patients across a wide variety of areas. The Irish Pharmaceutical Healthcare Association estimates that over 1,000 cancer patients are going to be impacted by the lack of funding. I do not accept that we do not have the money for this. I accept that this Government has made choices and that these choices are going to harm people. The Irish Cancer Society has made it abundantly clear that there is a real risk that cancer outcomes could decline in the years ahead due to the Government's health budget. It is simply not good enough that the Government could not find the €20 million needed to invest in a cancer strategy. Cancer touches almost everyone's life in some way, either directly or through a close friend or family member. Nobody could stand here and honestly say that the funding of our cancer service is something that should have been left behind.

When looking at our clinical strategies, we are looking at the likes of stroke or sepsis, which I spoke about last week. Some 15,000 people contract sepsis in Ireland every year. It is one of our biggest killers, with the Royal College of Surgeons saying that sepsis can be a contributing factor in up to 60% of all hospital deaths. The Government's own sepsis strategy says it is down around 25% to 30% but those are still huge numbers. Mental health funding has also taken a hit. Over the last two weeks, I have heard from a number of my constituents and from organisations all over the country who have expressed their worry about the lack of mental health services funding going into the new year. Ministers are patting themselves on the back this week for a slight increase in some services but that is not what the services on the ground are reporting back to me and my colleagues. A total of 44% of Irish people surveyed had difficulty receiving treatment for mental health issues, compared to the EU average of 25%. In a country that has a shameful history of dealing with people with mental illness and mental health, it is no surprise that our percentages are so high and so out of whack with the EU average. That is all the more reason we need to double down and ensure that, when it comes to mental health and mental illness funding, organisations and the HSE can plan for years ahead and have certainty of funding. That, again, has been taken away.

Along with proper funding for our health service, we also need proactive action so we do not find ourselves in this position again next year. Last week, the Tánaiste said in response to my party's leader, Deputy Bacik, that there would be a need for a deep dive to examine spending on the health service. It is 2023. It is long past the time to have a deep dive. The excuse that there was unforeseen demand does not wash. Our health service should be at the forefront of all our State agencies and Departments, working cross-departmentally to ensure we are seeing what demand is going to be, that we are working with population projections and growth projections. It is simply not good enough to throw the hands up in the air and say that inflation, unforeseen demand and a runaway budget is the cause of this. This is the fault of this Government. This Government has made choices with this budget. These choices are going to harm patient outcomes, sick people are going to get sicker and very sick people could end up dying. That is the legacy of budget 2024 in health.

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