David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I thank all the speakers who contributed to this debate. The three Ministers who spoke did their best to put a gloss on what was a disastrous budget for health for 2024. However, the facts expose the budget in health as the emperor with no clothes. It is very clear to anybody who is looking at what is happening in our health service and for the budget next year that the health service is underfunded and it will have dire consequences for patients. If the Government does not provide enough money for the health service to stand still, then the health service will go backwards. The Government, at best, is trying to pretend it has provided enough money for the health service to stand still.

At the Oireachtas Joint Committee on Health today, the head of the Department of Health talked about consolidating - that next year was the year to consolidate. It is not possible to consolidate the health service if it is not even provided with enough money to stand still. However, what is a certainty is that the Government did not provide the additional funding, which is needed to advance healthcare, to move forward and to deal with the 1 million people on some form of health waiting list, those on acute waiting lists, diagnostics and the community, and with the fact that we have far too many patients on hospital trolleys. Children with spina bifida and scoliosis have been waiting far too long for treatment. All of the challenges we have in the healthcare system, and there are many, simply will not be dealt with.

I agree with one thing the Minister for Health said in his contribution. He mentioned some of the negative comments which have been attributed to the health service. He conceded they were not made by people in this Chamber. It may have been some media commentators or others; I am not sure who he was talking about. However, the reason he had to say that is that some in government tried to shift the blame away from the three heads of Government, who signed off on a budget to deliberately and consciously underfund the health service, and onto what has been described as a runaway train that is the HSE and health spending.

I would certainly not pretend that we cannot achieve efficiencies in healthcare. Time and again I have given chapter and verse, pointing out that outsourcing, agency spend and spending more of taxpayers' money on subsidising private healthcare, which have been allowed to skyrocket over decades of mismanagement of public money when it comes to healthcare, is one of the reasons we have the problems we have now.

I asked the head of the HSE today even if we were to achieve the efficiencies he is seeking to achieve next year, whether we would still be running a very significant deficit. He confirmed that we would. He agreed with the point I put to him that he has been put in an impossible position of being asked to write a national service plan for next year which is essentially a work of fiction because he is being asked to build into it a deficit of about €1.3 billion. That is not a way to fund the health service. What we actually need to be doing is providing multi-annual funding to the health service, to all of our clinical programmes, to our national strategies at our hospitals, and to primary and community care to deliver the services they need to deliver.

The head of the HSE made the point today, and it was picked up by many in the media, that because we have people who are getting sick and because of where they get treated, we simply cannot cope with that in the future. We have to make sure that more people are treated at home or in the community. Of course, that is the case. That was the whole tenet of Sláintecare. However, there was not a single cent of additional investment of any substance in primary and community care for next year. The Government has agreed to, at best, stand still but not even stand still because it has not provided enough money even to do that. That is not my problem; that is the Government's fault - the fault of the three parties in government.

I cannot support the Government amendment. It falls even on its own false information, as I pointed out in my opening contribution, in bigging up the additional investment which has not actually been made. The Government and the three heads of Government need to take responsibility for their absolute failure to fund the health service properly. I have no doubt that as the days, weeks and months go by, for the rest of this year and next year, patients and those who work on the front line in healthcare will feel the consequences of that disastrous decision. Again, I support the motion we have put forward.

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