Seán Sherlock (Cork East, Labour) | Oireachtas source

The Labour Party will support the motion. We note the Government's countermotion, in which there seems to be a strong emphasis on all the moneys being spent by the Government across a whole range of areas, from CAMHS to the capital expenditure on infrastructure right through to things like BusConnects. Nobody would discount the fact that the Government has expended large amounts of taxpayers' money on these projected projects, but what we are not seeing is the delivery of these projects. I think the reason people get so annoyed and vexed about things like bike sheds and the costs of modular dwellings and security huts is that if they do not see the basic services being provided to them, services to which they are entitled by dint of the fact that they are taxpayers and have contributed, those issues get multiplied tenfold. It is a reflection of the anger people feel about the lack of delivery of basic public services.

A central theme tonight is child and adolescent mental health services, but it seems to me that the key driver of a shortage of those services is the lack of investment in talent. There are labour shortages across a whole range of medical and other skill sets, like audiology, physiotherapy - all the therapies. There are major shortages across all those disciplines. Taking post-recovery as being 2016 or slightly before, these issues were writ large in 2015, 2016 and right through to 2024. However, one does not see the emphasis by the Government on the issue of ensuring an investment in people and attracting the talent that is necessary to meet the lack of services available right across issues like CAMHS, nursing and doctors. Infrastructural projects cannot be delivered or are coming in at a massive cost because of labour shortages.

There was a wonderful opportunity for the Government to say in the budget announced last week that it would invest in people and in meeting the skills shortages that are there. It did not even talk about those skills shortages. It threw money out at every kind of mechanism and measure and it just made people angry. I think the mobile phone pouch issue is an articulation of that anger. If moneys were available and services were being populated by the requisite skills, I am not sure people would have been so vexed about mobile phone pouches, the cost of the bike shed or even the cost of the security hut, to be frank. What really annoys people, however, my constituents in particular, is where, for instance, I am talking to people in Mallow General Hospital and they tell me they now have to cut lists for procedures because of the lack of haematology services as one cannot backfill or there is not the requisite number of whole-time equivalents. That is what annoys people. If I am talking to a mother of a child and the child cannot access an assessment of needs or get the follow-on therapies that are required, like audiology, physiotherapy, psychology - all the "ologies" you care to mention - because of a lack of the requisite skills, that is a major issue for that family. The Government has not focused on backfilling the skills shortages.

As regards my tertiary hospital, Cork University Hospital, for instance, I got quite vexed in 2023 when I discovered that management in CUH had spent over €600,000 on outside consultancy services for advices on management functions at a time when the trolleys were coming out the door of the accident and emergency - and that was in 2023. Fast-forward to 2024 and the lists have not reduced in any great shape or form and the same system still persists. There is a disconnect between where the Government is and where the people are as regards filling the shortages of skills that are so necessary for the people waiting for CAMHS, the people waiting for elective procedures and urgent procedures in hospitals and the people waiting for services to flow in through schools and right across society. That is where people are getting really annoyed.

The countermotion refers to BusConnects. There was a briefing last night in Cork provided by Bus Éireann on BusConnects. Councillor John Maher and Councillor Peter Horgan attended and asked the simple question, "How many drivers short are you at present in Bus Éireann in Cork?" The answer came back that in May and June it was short 42 drivers, that it is now 16 short, that 11 are in training, that 70 drivers would be needed for the first phase of BusConnects and that 170 would be needed in total. To be fair to those city councillors, they are scratching their heads and asking the question, as I am sure Bus Éireann is, how will it fill those 170 vacancies? Again, it is an example of where vacancies arise. There are nearly 900 vacancies across the Cork-Kerry HSE south region in respect of hospitals, and there has not been a breakdown as to where those shortages are. We get headline figures based on parliamentary question replies - administrative, acute, non-acute, etc. - but no further breakdowns.

The dogs in the street, however, know that we have a shortage of nurses, doctors and specialist disciplines throughout the hospital system. We submitted parliamentary questions on the costs of recruitment accruing to the HSE in procuring external consultants. The reply to one such parliamentary question told me the HSE had spent €15 million. We are not seeing the throughput of skills. That must be the overarching and abiding focus of the Government. The way in which to provide services is to fill the vacancies. If vacancies are filled, the services flow from there.

Child and adult mental health services are the bread and butter. Every child deserves access to a service, regardless of where, or who, he or she is. If the services are telling us they cannot recruit, and if the Government is funding the HSE or each of these CDNTs or primary care teams, then the Government has to put the focus on ensuring it goes out to the world to fill the vacancies when they arise and make it a core policy of the Government to ensure that people who need a service can get access to it as and when they need it.

The Government, for quite a number of years, has taken the foot off the pedal. While we all understand people will travel once they have attained their degrees and some level of professional competency, and that is entirely understandable, the market, and I use the word “market” intentionally, for skills is a global one. It is agnostic in terms of nationality. There are plenty of programmes such as the one that is now being provided for GPs in primary care centres, which has had some measure of success. That needs to be replicated right across the system. Notwithstanding the massive cost of public money spent on things like bike sheds, security huts, mobile phone pouches and so on, a lot of these things can be dealt with. What people essentially want are public services and the skilled people to deliver them.

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