Matt Shanahan (Waterford, Independent) | Oireachtas source

I have sympathy to a point for the position Government finds itself in with runaway budgets and the difficulties of trying to rein in spending, but a recruitment freeze is a very blunt instrument to use. It cuts across all systems, including community, acute and primary care. It does not offer any help with trying to figure out who is actually doing a good job and who is not, or even more importantly, what areas are most in deficit with respect to staff, as opposed to those that are not. We have that imbalance throughout the health service and it is something we have not really tried to address. The recruitment ban is penalising all systems in healthcare at present and I cannot see how that can be placed anywhere as being within the interests of patients.

I will speak to our model 4 hospital in Waterford. I bring it up because, not surprisingly, I am deeply engaged with the issues at the hospital. We had a commitment to open the hospital up for seven-day cardiac cath lab access. Back in July the Minister visited the hospital and graciously came to meet staff on the ground and welcome the opening of the second cath lab, which I welcomed too. However, I pointed out at the time there was no budget to implement seven-day opening even though the Minister offered to the staff that it was his intention the hospital would move to seven-day opening at the end of the year. I told all and sundry there was no budget in place. How could that not have been known before the recruitment freeze came in? Given the freeze, we are in the position that if these people are to be recruited, a derogation will have to be sought. I hope that is what the Minister does, because it is one commitment Government has given that it cannot turn away from. We must get seven-day cardiac cath lab access for heart attack patients on the weekend.

Beyond that, as part of the end of Covid and the problems of the closure of Wexford hospital due to a fire, the Government opened an additional step-down facility up in Kilcreene hospital to provide orthopaedic and surgical step-down care. There were between 12 and 18 beds being operated and a business plan had been put in at some point to show 18 beds could be operated, and that was having a very marked impact on day cases and admissions at University Hospital Waterford, UHW. It was being done very efficiently by UHW staff on the ground in Kilkenny, but that has had to be stopped. That activity has ceased. Part of that, and nothing to do with the HSE freeze, is the money burned up from the UHW budget in dealing with the fire at the hospital. I understand there is a very substantial, multimillion euro bill awaited by the Ireland East Hospital Group to recompense the hospital in Waterford and the question is why it should stop services because it cannot get another part of the system to pay it..

The other point I have is about consultant posts. We have two emergency consultant posts and a radiology post that have been held up for months by the consultant applications advisory committee and just as they are approved we are told it has to go back to the South/Southwest Hospital Group. What are the chances it will give us funding? I would say there is not very much chance.

I am struggling to understand the benefits of this health recruitment freeze as there is nothing targeted in it. Let us consider the digitisation of the health service and the need to try to bring efficiency monitoring into what people are doing. Earlier, the Taoiseach was asked a question about the health freeze and he said there was not one as nurses could still be recruited. I am not sure whether the Minister can provide any clarity on that. The Taoiseach said it was still possible to recruit nurses but that is not the information I am getting. We cannot recruit anybody in Waterford and from talking to other people across the system, the impression is they cannot either. Returning to the issue of efficiency and digitisation, the Minister needs to start tackling the efficiency of hospitals, especially in the acute sector, and look at who is doing what well and who is not. Rather than bringing in this blanket ban on recruitment, he should start to look at the hospitals he said earlier in the year he was going to reward for the efficiency metrics they have gained rather than penalising hospitals across the board with the recruitment freeze.

I welcome the motion because it draws attention to the fact that the freeze is not going to work. It is not going to work for patients, it is not going to work in the system and it is not going to reduce the budget very much either. We wait to see what other plans the Minister might announce.

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