Mattie McGrath (Tipperary, Independent) | Oireachtas source

I thank the Deputies of all parties who have supported this motion. I wish to express my sympathies to Deputy Michael Collins on his tragic loss and to his brother Danny and the mother of the young man. I thank Tríona and Brian Ó Domhnaill in our office for putting this motion together.

I am disappointed because, as usual, the Government has put forward a countermotion. Everyone knows that something is wrong. Somebody quoted figures earlier and said that spending has increased by €800 million, or 40%, since 2019. It might be true but this is not about money. It is about mismanagement and pure neglect of rural and urban areas. GPs are not valued or respected. They have an ever-increasing workload. In my county, there are advertisements on Tipp FM and other radio stations asking people not to attend Limerick University Hospital or Tipperary University Hospital, and instead to go to their GPs, but you cannot get a GP appointment. Somebody phoned a GP practice last week to be told there is a waiting list of two and a half weeks and it was not an emergency. This woman wanted her blood pressure checked so this could very well become an emergency. There is unbelievable pressure on GPs.

This motion is fair and balanced. It is calling for an interdepartmental group to be set up to report back in a short number of weeks, and to do something about this rather than just turning paper and speaking volumes of words. Deputy Harkin raised the case of women who have had mastectomies being unable to access post-mastectomy services. There is shocking cruelty and inhumanity inside the HSE. We know there are thousands of good people working in the HSE and thousands of good things happen there. We saw the poor unfortunate young adults suffering with scoliosis in the Public Gallery last night. They have been suffering for so long and have had to come to protest outside the gates of Leinster House and come into the Public Gallery to appeal. This has been going on every year but has not been dealt with. Why is the system so inhumane that it cannot realise that it has to deal with these children with scoliosis. I could talk about a plethora of areas.

Former TD Dr. Michael Harty was elected here on a "no doctor, no village" ticket. It was a wonderful campaign. How right he was. The Government asked him to chair the Oireachtas Committee on the Future of Healthcare, which he did. He spent hours and months of dedicated time. As we approach the seventh anniversary of the announcement of Sláintecare in May, nothing has really happened under Sláintecare. That is what is wrong in this system. We keep producing reports and carrying out investigations and inquiries, and we keep making the system bigger and fatter and doling out largesse, but there are no services on the ground. We were told recently that the HSE recruited 1,000 people last year. I would love to know how many were pen pushers. I would say 92% of them were. This is the problem. It has just got bigger and bigger, has cannibalised itself and is unfit for purpose.

We have heard our colleagues here mention many areas around the country. I remember that when I was a young fellow, GPs could come out to you but now they are overwhelmed. The Government has rolled out different schemes, such as free GP care for the under-sixes, and after that for those under the age of 12, and the free contraception scheme. It rolls out any scheme it likes without proper consultation. There are the two GP associations, but they are like all the others - they are organs of the Government. When they arrive in Government Buildings for negotiations, they cave in and forget their members on the ground.

I salute GPs up and down the country and their staff, including nursing and ancillary staff, for the way they deal with people and try to manage the situation. However, I am critical of diagnosis by receptionists, which has been happening since Covid and involves a person being diagnosed over the phone or by someone standing in front of them through a glass screen. They have suddenly become GPs and can diagnose you just by asking questions. This is very poor practice, but it is happening wholesale. I hear awfully embarrassing stories about receptionists asking awful questions in front of a full waiting room, shouting through a screen, asking where somebody has a pain and how they feel, throwing the person a urine bottle and asking him or her to fill it up. That is inhumane. That is the pressure GPs are under. People cannot get to see them.

The figures are there. The Minister of State quoted them. We know the number of doctors who are going to retire. The Minister of State has figures regarding having so many doctors per 12,000 population. The Government is failing in respect of every figure it has nominated. It is failing the people. Two iarthaoisigh, Bertie Ahern and Brian Cowen, told me at different times that they were going to abolish the HSE but instead it has got bigger and more powerful and there are more cover-ups. It has become more unaccountable and disrespectful to the people and to public representatives.

I would like to speak about the primary care centres that are built. We closed a hospital in Carrick-on-Suir but a primary care white elephant was built on a flood plain and is three quarters empty. I have heard stories today about primary care centres. Money was spent on a brand-new nursing unit in Nenagh. It was built and kitted out but there is nobody to staff it. What kind of lack of joined-up thinking is going on? This is the problem.

The ongoing issue of the construction of the national children's hospital is having a damaging effect on children. First of all, it is in the wrong place. It will never be a proper hospital. It will never be accessible, with only a small helipad on the third floor. There is blackguarding, waste and unaccountability. CEO after CEO comes in and gets huge remuneration packages with no accountability. If you ask a question of the Minister here, he will tell you that it is a matter for the HSE. It is a handy stalking horse to fob people off - to hell or to Connacht, or go where you like. We do not have the resources we should have.

I also want to mention dental care, where there are significant pressures under the GMS system. Dentists just cannot take patients on anymore. Any time I visit my dentist on the quay in Cluain Meala, he is so concerned. He is a wonderful man. He is getting on in age like any of us but there is nobody to replace him and the system is being abandoned. We will see the Minister addressing the doctor's conference in early summer.

We will hear about the great things that are happening. The Minister is sent out to read scripts, as the Minister of State, Deputy Naughton, does. I acknowledge there are good things happening, but our GPs are the lifeblood of our community. What is going in Swanlinbar, as Deputy Harkin mentioned, is happening everywhere. Practices are being taken out of rural villages. Bigger primary care centres are taking them over but they have no interest in them really. They want the people from rural areas to go in to the town - isteach go dtí an baile - which means that there is less and less service.

The rural GP services, the nurses in them and the different dispensaries all over the country did a valuable job for decades. Now the HSE will not give them any proper supports. If a place is closed down or a doctor is retiring, they have to build a new centre themselves. There is no proper funding for that. They have insurance. They have health insurance, obviously, or mitigation against claims. They have all kinds of issues - light, heat, you name it. Really, they are small businesses. They might have up to ten staff.

The Minister of State's eye is not on the ball here, and neither is the Government's. I do not know what is to come over the Government, as I have said here. Sláintecare is a grandiose and glamorous document. The former Deputy Harty chaired that committee, but the report is not being implemented. We keep doing reports. We keep doing more and more reports and renting office space all over the country to store these reports instead of taking action. It is time that the Ministers ponied up.

The Minister, Deputy Stephen Donnelly, did not deem it worthwhile to come in to address this motion today, nor did any of the Ministers of State say why he was not here. If he was out of the country or if he is sick, it is fair enough, but he has not even the interest in listening to us. The Minister knows it all and he does not want any solutions.

This motion is calling for practical solutions and for a task force to be set up to decide, once and for all, how to deal with this problem. It does not call for pushing paper and everything else, or for voting on motions only to let them fall into oblivion. In the past while, it has been the practice of the Government to accept motions and then put them into some pigeon hole somewhere and leave them there. Their job is to govern here. Their job is to deliver services for the people.

We have migration into the country. Everywhere you go, in every town and village, there is a huge explosion in population and no services for them - GPs, hospitals, dentists, schools, etc. It puts more pressure on. The Government has a will to destroy the public services we have out there for the public and to deny our people public services they are entitled to, such as basic fundamental healthcare. These are human rights. We have doctors going out to field hospitals doing cataract operations. Deputies Danny Healy-Rae and Michael Collins are bussing people up to Belfast to do them. We cannot do them here. The Government can find the money under that scheme. That scheme is operating on the reverse as well where people from the North and other countries are coming here for those operations. It is farcical in the extreme.

I ask the Government not to oppose this motion, to listen to the voice of reason - everyone who spoke here this morning - and to try to do something for the country to ensure we have some modicum of GP service again and take the pressure off the overworked GPs we have.

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