Paul Murphy (Dublin South West, RISE) | Oireachtas source

We have the worst hospital waiting lists in Europe, with more than 1.1 million people on some form of waiting list for healthcare. Incredibly, this is more than one in five of the population. Today, 563 people are on trolleys in hospitals throughout the country, with a record being shamefully broken at University Hospital Limerick when 130 people were waiting for admission there on Monday morning. We have 2.9 hospital beds per 1,000 people in this country, which is a little more than half the EU average of 5.3 beds. We have an unprecedentedly large budget surplus but, two weeks ago, the Government proposed a budget for a worse healthcare service. That is the blunt, shocking reality. A a time of plenty, the Government proposes a budget that will result in longer waiting lists, more people on trolleys, not delivering the beds that were previously promised and a recruitment freeze that will have devastating effects. I could quote a lot of people to back that up but most significant is what the CEO of the HSE has correctly been saying, namely, the simple reality that the funding to the health system is not adequate. He spoke about built-in deficits, which is the first time in my memory that this will be the case for service plans. It is quite incredible and it will have real-life impacts on ordinary people.

Dr. Rachel McNamara, chair of the non-consultant hospital doctor, NCHD, committee, of the Irish Medical Organisation, IMO, has stated:

This recruitment freeze flies in the face of safe staffing levels. It will add to the chaos in a system which already does not have enough doctors to deliver safe patient care, where many teams across the country are not fully staffed and where NCHDs are still working illegal and unsafe hours.

This situation points very directly away from Sláintecare, towards the delivery of which we are supposedly driving. This confirms for me that everyone signing up for Sláintecare is just a convenient political trick. We are told everyone has agreed on what will be done but the reality of the two- or even three-tier health service in this country continues and is actually deepened by the policies of the Government. Everyone gets to claim to support the model that looks a little like a national health service while the existing service continues in the opposite direction.

The question is why the Government decided to do this.

The superficial reason presented is that the Minister for Public Expenditure, National Development Plan Delivery and Reform, Deputy Donohoe, wants to keep the Department of Health and its Minister on a tight leash. This is the idea that he does not have control over the budget and the Department of public expenditure is not going to give it enough money, so he will have to come back asking for more at short notice and it will give him only a little more when needed in order that he will not run away with himself.

Even if that were true, although I do not think it is a very deep analysis of what is happening here, it would be quite an incredible step for the Government or the Minister, Deputy Donohoe, to take. It would be punishing patients and our health service, and proposing and passing a budget that will mean a worse health service, to rein in a profligate Minister. If the rest of the Government does not have confidence in the Minister for Health, they should act to remove him, rather than undermine and destroy our health service.

I think the deeper reason is that it suits the mainstream narrative of Fianna Fáil and Fine Gael to go along with the idea the health service is some sort of black hole. Every year, in every budget, we hear there is more money for health than ever before and that it is the largest budget for health. Of course it is the largest budget for health; we have such a thing at the moment, particularly in medical costs, as inflation, and we have population growth. To stand still, the health budget needs to get bigger. The cheapest way to deliver high-quality healthcare, however, is with a public, one-tier health service. That is the cheapest, best quality and best value-for-money way to do it, and it is the Government’s undermining of a quality public health service that is creating inefficiencies. If we get rid of direct employment, we will have to pay more for agency staff. If we outsource all our catering, cleaning and everything else, we will pay more than we will by doing it directly and inhouse.

Similarly, we do not develop capacity within the hospitals and then we export people and continue to promote a private health service through the National Treatment Purchase Fund. At a time when our health service is creaking and is going to get worse as a result of political decisions, the private hospital sector is making big profits. Last year, Larry Goodman's Blackrock Clinic reported a doubling of profits, to €14.5 million on revenues of almost €160 million. A fundamental cause of the crisis in health is the fact people make profit from it, and the answer is a national health service.

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