Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I am sharing my time with my colleague, Deputy Alan Kelly. I want to acknowledge and support the Minister's words spoke regarding our international workers in our healthcare service. Without them, our health service would cease to function in any way, shape or form. We have all said it before but it is always worth repeating. However, we have massive issues in our health service, regardless of what the Minister set out in his speech. We need to move towards a system of universal healthcare because we do not have it at the moment. The disparity between public and private healthcare in this country is stark. We see it in waiting times and in access to new medicines in a number of different areas, particularly in oncology. If people have private health insurance, their clinician can ring an insurer, ask for a new medicine and that can be arranged in a relatively short time. If they are in the public system, they are not only going through a multistep process for that new medicine, that process can take upwards to two and a half to three years for the reimbursement. That is what a two-tier health system looks like. Unfortunately, what has become apparent to people is that the difference between the two systems is that one can deliver better outcomes while the outcomes are not as good in the other. Unfortunately, the one in which the outcomes are not as good, more often than not, is the public system. That is not something we can stand over. We need to invest further in primary care. The recruitment ban, which has been batted back and forth across this Chamber now for many months, needs to come to an end. The Minister and the Government will say there is no recruitment ban and that too many people have been hired. I and others will say, in a town like Swords, we have not had a social worker for a year and we are not able to hire any more because of the recruitment ban. That is the reality of it. A town of more than 50,000 people, due to grow to 100,000, does not have a social worker. That is what the recruitment ban is. It is nothing else but a ban on hiring front-line staff who need to provide front-line care in their community and there is no way of the Minister spinning his way out of that one.

We have an issue relating to primary care centres as well. Swords is the largest town in Ireland without a primary care centre. One has been promised now for ten years. There has been planning permission for one, which will include a day hospital, but now the HSE says it cannot afford it because the developer says the price that was agreed is no longer viable. How has that level of poor planning been allowed, given the need in that area? The population of Fingal in 1986, one year before Beaumont Hospital opened, was 138,000. It now stands at 330,000, yet we still rely on Beaumont Hospital, which s spread far too thinly.

I will finish on this last point before handing over to Deputy Kelly. There is a major crisis brewing and existing regarding our medical scientists. We discussed medical scientists a lot during the pay parity dispute but we have a situation now that can be resolved somewhat with changes to CORU registration to make it easier for medical scientists to get registered to work in our public laboratories. I will be bringing this to the Minister again in the coming weeks. I am just flagging it here. We have more tests than ever. We have less staff than ever. To highlight this, we have people walking out of the public health system as permanent pensionable workers, to go work for an agency to come back into the same laboratory to work side by side with public staff. The use of agency staff is highly problematic. It should only happen in an emergency. What we should never have is people feeling it is more financially beneficial to leave the public system and work as agency staff. I will bring this up again soon.

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