John McGuinness (Carlow-Kilkenny, Fianna Fail) | Oireachtas source

I will focus on a number of issues that are of concern to me and paint a picture of a health service that is not responsive to the issues being faced by families and individuals. I have raised them a number of times and until such time as the services are delivered, I will not be able to say we have a functioning, efficient health service. That is no reflection on the staff on the front line. It is about bureaucracy, the direction of spend, which comes through the Minister to the HSE, and the nightmare of dealing with the HSE for any individual.

The delivery of mental health services is appalling. In my constituency office, I have had numerous complaints from patients and the families of patients that they are not getting the level of service and extent of professional supports that are needed to deal with the issues at hand. Therefore, I cannot say it is a service I have confidence in. We need a new building in Kilkenny hospital to deal with the department of psychiatry. That is programmed in the capital programme. We need to put emphasis on it and deliver it rather than talk about it. While that modern facility is being delivered, the range of professionals that are necessary in any modern mental health service should be recruited. We cannot get young children in to see child psychiatrists. It is absolutely appalling. When dealing with the youngest in society who are challenged in this way, there is an obligation on this House, the Minister and the HSE to insist that those who are vulnerable are dealt with and that the families who know their children need a child psychiatrist are supported. That is not happening and I do not see any changes being made. All I witness is several GPs in Kilkenny referring clients to a child psychiatrist for that psychiatrist to refuse to accept the child for one reason or another. If a GP sees a child and determines he, she or they needs a child psychiatrist and an assessment, no obstacle should be placed in the way of delivering that.

The facilities required by the families of children with autism are one of the biggest problems. There is insufficient focus on that issue. It requires a huge number of various professionals. We do not seem to be making any inroads into recruiting those professionals to deliver the necessary services an assessment has highlighted for any child with autism. Much more needs to be done and greater investment is needed. Again, we are back to the professionals.

Drugs are now a scourge on every community. There is no community that is not affected by them. Families are crippled by having to deal with a son or daughter who is caught up in drugs and the drug barons who threaten the lives of some of those who owe money to them. Despite this, it seems we are not dealing with the issue under the law. We do not have the resources there or through the HSE to support the families of those affected. In fact, in terms of the law, it seems we now can accept a murder, rape, knife attack or beating and it does not raise any heads, whereas before it would not have been common. Now, it is far too common and it is about time the authorities that manage An Garda Síochána woke up to the problems we have in society in that way and look at the drugs epidemic that is the source of many of these problems.

I wholeheartedly agree that primary care is the proper way to deliver healthcare but it needs money. In Kilkenny, people who worked abroad and are now returning home cannot get a local GP to take them on. They either join the queue or are left in limbo. That does not speak to a modern dynamic country and economy. It is backward. Much more needs to be done. If it is a case of bringing back the doctors and nurses who were trained here and giving them better wages and working conditions, so be it.

Spend the money in that way because there is plenty of money being squandered through the health services and through other Departments and agencies. Maybe if we were to manage and plan our spend far better, we would have the services, the professionals and the GPs.

The Ballyhale primary care centre is being held up by the bureaucracy that analyses and assesses it and that has not short-circuited, delivered and properly funded it. The community of Ballyhale and beyond cannot say they have a primary care centre and a HSE that is responsive to all of its needs.

Hospitals will now make a plan with families of patients to take their family member home to be cared for. It is almost as if the hospital will tell the family anything to get their family member out of the hospital bed. The hospital will promise any amount of hours to get the patient home. It will do everything possible to get the person to vacate the bed and once the patient is at home, the services simply fall off a cliff. The services cannot meet the hours and they cannot recruit or deliver. Again, if that is down to money, surely the Department of Health can examine it. I have seen money spent through the HSE that does not deliver value for money and is not worthwhile spending. That needs to be addressed. If it is the case that people need to have home carers or other supports at home, those should be delivered. If they cannot be delivered because of the cost of the professional, worker or carer who goes into the home, then we need to look at salaries. There is no point in failing to deliver a service and then paying outsourced workers an inflated salary to deliver a number of hours of care in support of a family.

Teac Tom is a project in Kilkenny that has applied for section 39 status and funding. It was promised it would be included from January 2024 because it is worthwhile and delivers. Teac Tom has not yet received a response to its application. Will the Minister of State take up the matter with the HSE and the Department and tell me when the application will be processed and the decision made and when Teac Tom will receive its money? This delay is putting enormous stress on the organisation, the families it serves and the individuals who go to Teac Tom for assistance. It is the same story right across the agencies, which face uncertainty about getting funding and having it delivered.

Nursing and care within the Defence Forces are another big issue. Private outsourced nurses are delivering healthcare to Defence Forces members but they are not being made permanent within the Defence Forces. We are paying an outside agency. In spite of pleas to the Minister and the person in charge of James Stephens Barracks to have the individual in question made permanent, it has not happened. The person has been in the job for a long number of years. Surely to God there is an onus on the State to ensure individuals are appointed where it is necessary to do so, including in cases where they are caring for members of the Defence Forces. Many speeches have been made in this House in support of the Defence Forces but with regard to the basic healthcare of Defence Forces members, the staff and professionals delivering these services are not being cared for in their terms and conditions of employment. I ask that this be addressed by the HSE or the Department of Health. It is a necessary service and one that has to be delivered daily. As a result of the trauma now being experienced by those who serve abroad, there will be an even greater demand for mental health services and support services. If we do not have the courage to look at that and make sure Defence Forces members are looked after, then the ordinary citizen of the State has no chance.

In summary, the elderly in our society are being badly served by the HSE. The marginalised and those left forever on waiting lists are badly served by the HSE. I see no real plan to cut all of this down, cut out the bureaucracy and deliver the services that are being demanded.

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