Alan Kelly (Tipperary, Labour) | Oireachtas source

I had to grin earlier because, whenever the Minister is in the Chamber, I seem to have to go out to take a phone call about my father's healthcare. The work of the staff in both Limerick and Nenagh, whom I have been dealing with in the past few months again, has been exceptional. I acknowledge Dr. Scott, Dr. Sohail, Dr. Vijay, healthcare assistant Ray, nurse manager Louise, healthcare attendants Patrick and Tom, nurse Ionela, nurse Ji Ji and nurse Johncy. It is important to acknowledge that, despite all the issues we have in our health system and that we debate here, there are real people looking after very sick people in our care. They deserve to be acknowledged.

As the Minister knows, I am exceptionally familiar with the mid-west. I do not think I have spoken more about anything than issues in the mid-west in my political career. I preface all my comments based on my knowledge of it. In my office, there is a corriboard poster from 2005 or 2004. It was left there by a previous Labour Party representative, Kathleen O'Meara, who worked very hard on fighting the Hanly report. In fairness to the Minister, I acknowledge he has always said the reconfiguration in the mid-west did not work. It should never have happened. The clinicians who actually advised that it be done have never answered questions about it but politicians have had to face it. The Minister has had to, and so indeed did I when I sat where he is now sitting. Clinicians have never had to face it. It is very difficult for politicians to go against clinical advice. In this scenario, the resources were not available and politicians should have gone against clinical advice because what was to be put in place was never going to work at the scale required. We are now trying to backfill at a rate. I acknowledge there is work going on.

There are issues concerning staffing. I acknowledge everything the Minister has said in this regard but there are issues and processes in place that mean the bureaucracy around filling certain posts is ridiculous. Some posts are left open. In this regard, I refer to my colleague Louise Morgan Walsh, who works in Nenagh hospital, and other staff in a range of other settings. Positions have been left vacant for over a year. I know of someone who was considering applying for a position but who went to Australia. That individual came back for a family event the following year and the position was still not filled. That is just ridiculous.

The Minister referred to the pay and numbers strategy. I have spoken to representatives of the unions and will be supporting them in their campaign, but I have also spoken to people across the HSE who talk to us because they believe the relevant information needs to be in circulation. There are qualified people on panels that have been in place for months or years but the related positions are never filled. The Minister states there is prioritisation in each region. I support that but the gaps that exist are simply not acceptable in some scenarios. I will give a classic and very important example. Cancer care in UHL is the best in Ireland, and the KPIs show that. In the past five years, particularly during the Covid pandemic, so many people have told me how brilliant it is. I know about it personally – trust me – but the fact is that the posts involved, such as in nursing, are very specialised. The numbers are down and, for the first time ever, people are saying to me that they do not have enough nurses and that hospital KPIs are slipping. I have raised this with the Minister before, including a month ago, but the position is still the same. Scalp treatment is not happening.

There is a discrepancy between what the Minister states about funding and what happens on the ground. What is required is happening in some cases but not in others. The reason has nothing to do with funding; it is that there is nobody to do the work. The staff are not in place. There is an effort to prioritise the treatment of cancer patients based on need. Unfortunately, some have to wait a little longer because they are not as great a priority. That is a clinical decision, which is fair enough, but the KPIs are dropping. That is just one example. It should not arise. I actually believe the Minister believes it should not arise and in that regard I am not making a political point, but the bureaucracy and what is left in place regarding the prioritisation of the filling of posts within each regional division – some of the regions are not even set up fully – means what is required is not happening at the level it should.

I want to make several more points. The privatisation of much of the healthcare system is happening. I am aware that the Minister has referred to the comments of the chief executive in this regard. I accept Mr. Gloster's belief; I actually believe him when he states he wants to cut the amount by two thirds, but sometimes, because of the bureaucracy I have spoken about, the easy choice is to get agency staff. Advertisements that I could print off and show the Minister offer an incentive of €4,710 to come to Ireland to work. We need every one of the staff but also the people on panels.

I have sung so many times in here about the community nursing home in Nenagh being given over to a private company to run it. There are 15 or 16 people being held in a specially built 50-bed unit. It is the most modern nursing home in Ireland, yet it is left with 15 or 16 people. It is not making a huge difference to trolley figures because the issues in UHL are so much bigger.

I want to focus on a couple of specific points. The backfilling of positions that arise from retirements and maternity leave is simply not happening. Given the layers of bureaucracy, it takes so long to replace staff. I know of nurses in multiple settings in the mid-west who, although their shifts will be over at 5 o'clock this week, will be staying on till 9 o'clock. They are absolutely exhausted. I know them; they are my friends and neighbours.

When it comes to community care in the mid-west, many of the issues affecting UHL arise because too many people end up there who should not end up there in the first place. This is because the resources in the community are not up to the level required. I am going to beg the Minister for something I have spoken about so many times. I know all about home care packages and home help, given my domestic situation with my parents, both of whom are in their mid-80s. The Minister can announce a zillion home care packages and a zillion additional home help hours but these will not matter if we do not have the bloody people. The reason we will not have the people is that they are not getting paid enough and there is competition to do other work. I know people who were doing home care but who went off to work in other settings because they were just better. We need a registered employment agreement that sets the basic hours, pay, travel expenses and all the extras associated with the work. This would save the State money because it would help people to stay in their homes rather than end up in big, freezing nursing homes or in acute care costing €1,600 per night. I beg of the Minister to push this.

In my remaining time, I want to put something on the record that I asked the Taoiseach about yesterday.

I have four questions. We need dates before the election. A commitment was given that the new 96-bed block in University Hospital Limerick, which I look at multiple times a week, staring out the window, would be opened in the first quarter, to be fair to the Minister-----

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