Catherine Connolly (Galway West, Independent) | Oireachtas source

The Minister of State has; it is not pleasant. Somebody related to a person who works with me spent time on a trolley in a hospital in Dublin today and it was utterly chaotic. I have been a Member of the House since 2016 and nothing has changed. Representatives of HIQA attended the regional hospital last year. The hospital serves almost 1 million people. HIQA stated in March last year that the emergency department was grossly overcrowded. There were something like 27 people on trolleys at that time; today there are 33.

On 6 March, we had 52 so it is an ongoing problem and there is ongoing pressure. All of the Members on the Government side nodded when I asked whether they had ever been on trolleys but I would like to know how long they spent on trolleys because it would not be unusual in Galway to spend between 24 hours and six days on a trolley depending on the season and phone calls to TDs. It is a desperate situation for the patient and the TDs to contact the hospital asking how many people are on trolleys.

This clearly tells us that hospitals are under-resourced, under-staffed and on occasions, badly managed. This is why we need primary care centres. In 2001, we rolled out a strategy but, unfortunately, that strategy has never been properly fulfilled or reviewed, so we see company after company setting up. Indeed the former CEO is now in one of those companies working with another big company owning the private care centres upon which this Government and the HSE are dependent. Health centres are either being built in public private partnerships or are completely private and then leased to the State at enormous rents. Those rents do not even satisfy the owners. We see from recent reports in the Irish Independentthat primary care centres have been stalled because they do not believe they are getting enough in rent. We have learned nothing from the financial crisis or the privatisation of medicine over and over again.

Could the Minister of State depart from his script in his reply and deal with the issues we are raising? We are not doing it to embarrass him. We are doing it because the system is a complete mess and the Government is relying on private for-profit companies to build the infrastructure for primary care. There is a primary care centre outside Merlin Park Hospital in Galway. I understand that the rent is €250,000 per year every single year with nothing to be gained by the State except helping companies to make profits. It is completely in the arms of private companies, which can determine the conditions. Surely at some stage, we should review the risk assessment and cost-effectiveness of such a model but we are not doing anything like that. In the heart of Connemara, i gcroílár na Gaeltachta níl plean ar bith le haghaidh ionad cúraim phríomhúil don cheantar. Ar an gCeathrú Rua, níl plean ar bith chun ionad príomhúil sláinte a chur ar fáil ansin. Tá siad ag caint faoi ionad sa Spidéal. Cad atá tarlaithe? Táimid ag fanacht ar an forbróir príobháideach chun é sin a sholáthar dúinn. Mura n-éiríonn leis nó léi, ní bheidh aon ionad cúraim phríomhúil againn. In the heart of Connemara, there is not a single plan for a primary care centre. The nearest plan is for Spiddal, which is in Chois Fharraige and will not serve the vast area of Connemara. Again, this is in the hands of a private developer. I have no problems with private developers but when we are utterly reliant on them, there is a problem. If they decide they are not building them for a range of reasons, for example, if they are in trouble or if there are planning problems, there is no primary care centre. That is the situation as I speak. We finally got one in Moycullen after many years - again, on a private basis.

The day centre in Áras Mhic Dara in Carraroe functions one day per week. The management tells us there is no demand for a day centre i gcroílár Connemara. Clifden hospital is closed. This was a wonderful hospital in theory with wonderful staff. We were told by the wise management a year ago that there was no demand for a district hospital. Then we were told there was a problem with staff and then we were told there was a union problem. Finally we were told that the new 40-bed nursing home - it was to have had 50 beds but the number was reduced to 40 - will solve all the problems. There is a misunderstanding here that a district hospital is the same as a nursing home and that a nursing home will fulfil the role the district hospital had. A GP stood up at a public meeting to appeal for the second time for the district hospital to be kept open.

The focus of the motion is primary care and improving conditions for GPs. We can do none of that unless we roll out the vision. The vision was set over 23 years ago but it was never rolled out. Indeed it was one of the reasons Deputy Shortall left the Labour Party. She left because of the manner in which that party in government dealt with the primary care strategy. Here we are in 2024. I would love it if the Minister of State would tell me in his reply how many primary care centres are owned by the State. How many centres are in planning but are held up for various reasons - financial or planning? When will there be a review of the primary care strategy? When will we have a review of the day centres, which constitute an essential piece of infrastructure to take pressure off hospitals?

When HIQA visited the regional hospital last year, it said it was grossly overcrowded. I told the Minister of State that the number was 25 or 27. This number has trebled on occasions since then so the term "grossly overcrowded" loses its meaning. If it was grossly overcrowded when the number was in the mid-twenties, what language will we use when the number is in the sixties as has been the case repeatedly? How do we keep going from crisis to crisis rather than building up the basic infrastructure that every town needs?

We go back to Carraroe. Where is the day centre? Since I entered the Dáil in 2016, I have amassed a library of replies about the transfer of land to enable a primary care centre to be built on Inishbofin but there is still no primary care centre there. It is the same with Inis Aran off the coast of Galway. It was promised a brand new primary care centre. I am here eight years and have never seen a review. I have never seen a Minister stand up and say this is unacceptable and we need to review this, take the pressure off the hospitals and give basic services to rural areas and towns. I will work with the Government. I would be delighted to hear some senior or junior Minister actually stand up and say that. Instead we go from crisis to crisis and we rely on the Irish Independent to tell us about the problems in the provision of primary care centres. We see people who are heading the HSE walk into other jobs in the private sector and benefit from their knowledge of what is needed rather than having learned our lesson from Covid and the financial crisis that certain services are essential to a civilised society. Primary care centres are one of those services. It makes sense on so many levels and yet here I am eight years later highlighting the absences on the ground reliant on a Sinn Féin motion to put pressure on a Government with the rest of us in opposition while the Government utterly fails to be honest and direct, tell us what the problem is and learn from its mistakes.

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