Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

The Government is far behind delivering on Sláintecare. Sláintecare's vision is to deliver one universal healthcare service for all, providing the right care in the right place at the right time. You would have to be living under a rock to believe this is actually what is happening on the ground. Tens of thousands of children are waiting for assessments of need, appointments for occupational therapy, speech and language therapy, psychology and the list goes on and on. When it comes to providing the right care at the right time, this Government has failed miserably.

There is also a situation where children are subject to a postcode lottery when it comes to care. For example, a child who is living in one part of the country may have easier access to the child and adolescent mental health services, CAMHS, than a child who is living in another part of the State. Care should be based on need and not based on where somebody is living. When it comes to providing the right care in the right place, the Government has also failed miserably.

At this stage, it is not a revamp of Sláintecare that is needed, it is a revamp of the Government that is needed. Only a Sinn Féin Government would deliver the changes in healthcare that our children desperately need. Sinn Féin has the plan to deliver universal healthcare. Sinn Féin has the ability and the ambition. The Government falsely accuses Sinn Féin all the time of not producing plans. In the last year alone, Deputy Cullinane has produced several health policy documents in order that Sinn Féin in government would hit the ground running. These include his consultation document, Priorities for Change in Health and Social Care, which I have to hand and which outlines the solution to the healthcare crisis the Government has presided over. They are ambitious, realistic, practical and deliverable solutions. Sinn Féin has also published another document I have to hand, Caring for the Communities. I can give the Minister a copy of these afterwards if he wants them although I am sure he has them already. This is Sinn Féin’s plan to improve local GP and health services. Also, in my role as spokesperson for mental health, I published Sinn Féin’s document on priorities for change in child and youth mental health. This includes solutions to reduce the waiting times for CAMHS, prioritising early intervention, and delivering integrated, person-centred care.

Another false accusation the Government constantly throws at Sinn Féin is regarding how we will pay for it. They ask where the money will come from. To underpin all that, we also produced an alternative health budget in 2024 and I will also give the Minister a copy of that. The time for change is now. We have seen waiting lists go on and get longer under this Government. It is not just a matter of waiting lists. It is also a matter of having the right access to care in the right places.

For example, if people cannot get an appointment with their GP, they are going to have to attend an accident and emergency department, which is happening more regularly. That is putting more pressure on some of the accident and emergency services we have.

Some of the key points I want to make are that Government has failed to deliver universal healthcare or make significant progress on affordability; medical card eligibility for most people has not been reviewed for two decades; and thresholds have not kept pace with inflation and rising wages. People are being pushed to the pins of their collars. It is very difficult for somebody when they have to go and see a GP. The minimum cost now for a GP appointment is €70. The decision for people is whether to go and see the GP to look after their healthcare needs or pay the rising gas or electricity bill or put food on the table. These are the real-life decisions people are making.

In 2020, the Government announced plans to extend free GP care for children up to and including 12-years-olds. The Government legislated for under-eights, under-tens and under-12s but stopped the funding at eight-year-olds. The monthly threshold for the drugs payment scheme, which reduces the cost of medicines and equipment for families who do not qualify for medical cards, now stands at €80. In 2001, which was 23 years ago, it was €53. That has not kept up with the cost of inflation or the cost of living. It is seriously pushing people to the pins of their collars. They ask whether they should get the medication they desperately need and collect their prescription or pay the gas bill, mortgage or rent. These are the choices people are being left with in the real world.

Universal healthcare is not just about affordability; it is also about accessibility. Existing entitlements are becoming worthless. Medical card holders struggle to find a dentist. It is great if somebody has a medical card, but then they try to access a dentist. Everyone is struggling to access their GP. As I said earlier, if people cannot get the time to see a GP or a GP has not got the ability to see them, they could ring a GP on a Monday and that GP might not be able to see them until the following Wednesday. If a person has a healthcare issue going on, as I said, he or she is more likely to attend an accident and emergency department, which puts more pressure on already pressurised accident and emergency services. The Minister mentioned UHL and places like that. This is happening right across the country. It is happening in my hospital in Tallaght where we see people waiting on trolleys for way too long in the accident and emergency department.

The Government has not capped or removed car parking charges despite promises to do so. I recall when I came here five years ago that this was one of the promises that was meant to be delivered and it has not happened. Half the population continues to rely on health insurance. Delivering universal healthcare is not just about funding fees or reduced costs. It also requires hospital and community capacity and workforce planning. This has not happened. The Minister announced 1,500 beds for hospitals several times, but the Government did not fund them. As a result, hospitals continue to be overcrowded, and the Minister rightly pointed UHL out.

Sinn Féin has a plan. In our alternative budget in 2024, which I showed the Minister a few minutes ago, we had an expansion of 400,000 medical cards. We had plans to cut the drugs payment scheme monthly threshold to €50. We had plans to reduce, cap and work to remove the car parking charges. Sinn Féin would deliver a transparent framework of income-based entitlements that sets out the path to universal coverage. We would diminish the need for private health insurance by investing in the public system, including 3,000 hospital and community beds that are needed to make hospitals accessible. We would bring accountability for workforce planning. This is something the Government has failed to do.

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