Matt Shanahan (Waterford, Independent) | Oireachtas source

I thank Sinn Féin for the opportunity to debate further the issues in our health service, which at this stage are legion. The planned HSE funding freeze is worrying. I am inclined to agree with my esteemed colleague, Deputy Canney, that the rationale is that Government is trying to put some manners on runaway HSE budgets. Anybody who has spent any time working in or around the healthcare industry knows we have a lot of inefficiencies. It leads to a lot of needless waste. That is yet to be tackled and is something we need to pay particular attention to. Like Deputy Canney, I worry about the message to workers, patients, families and those on long-term waiting lists. We are potentially causing people needless anxiety. I point out and have said recently in the House that we have a large number of no-shows for planned elective work in hospitals, for whatever reason. It runs anywhere from 15% to 30%. If we were to create an initiative around that, we would certainly manage to bite deeper and faster into the extensive waiting lists around the country and not spend a lot more money.

I will also speak about the problems of unstructured downsizing, which is where you take one metric and apply it to all hospitals, in particular in the acute hospital space. The Minister of State, Deputy Butler, will remember that around 2012, the Government created a cost-cutting measure in all hospitals in the country. University Hospital Waterford was the only model 4 hospital in the country that was under budget. One hospital in Dublin was more than 20% over. Everybody took a 7% cut in their budget. We were penalised because we did not overspend. Again, the problem is that if you cut in a broad way and it is non-selective and non-targeted, you will affect the hospitals lower down the food chain. Hospitals like ours in Waterford and University Hospital Limerick in particular will suffer most in terms of the model 4 configuration.

The Minister spoke about his productivity platform, or maybe it is a Department initiative, and about rewarding efficiency. I have said many times in this House that the acute model 4 hospital in Waterford is the most efficient emergency department in the country and the most efficient in terms of trolley count. When it came to doling out €650 million of capital spend this year for the nine model 4 hospitals, it was given to the other eight and University Hospital Waterford got nothing. This is despite the fact that it has pending permission secured for a laboratory build and for a vertical overhead. The Minister of State and I were on calls more than a year ago when these were being discussed and we were told they were approved. Yet they did not get done. We were told about an additional bed block, which looks to be gone now, along with the additional emergency beds. I pointed out to the Taoiseach this morning that we have two emergency department consultants approved since last March and these appointments have been sitting with South/South West Hospital Group, have not been approved, and have not been sent on to the consultant applications advisory committee, CAAC. Why is that? We are telling people on the one hand they are great, they are doing a great job, we are clapping them on the back, and we want to reward them, while on the other hand, there is no sign of that reward coming.

I made another point, of which the Minister of State is probably aware, which is that Waterford incurred significant patient charges consumables for the closure of Wexford emergency department. To my understanding, there has yet been no payment from Ireland East Hospital Group to reimburse Waterford's operations budget.

I will speak to digitisation. A number of years ago I did some work with a company, which was very successful in digital health right across America and western Europe. It is an Irish-based company. I asked the gentleman concerned why he was not looking at Ireland. He told me he had two representatives on the road for two years in Ireland. They had lots of meetings and positive reaction but did not sell a single system. He just gave it up and got out. Enterprise Ireland is still bringing that company around and introducing it to foreign customers in exposés throughout Europe and it still has not sold into Ireland. We are not able to do it. I say that what gets measured gets managed. Deputy Troy, Deputy Naughten and I are bringing an expert group on digitisation into the audiovisual room in November. I encourage anybody here to come along and hear what has to be said. This is how we might potentially supercharge our health system and introduce the real measurement efficiencies that will drive future service plans. Until we do that, we will keep going round in circles. We will not manage because we cannot measure and we will hurt the systems, which at this moment are the most efficient and the ones that need the most support but are not getting it.

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