David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I start by wishing the Minister well. I think is the first chance we have had in the Dáil to formally do that. I also acknowledge the contribution that the former Minister for Health, Deputy Stephen Donnelly made as well. It is important to put that on record. We had many exchanges but there are areas of healthcare, particularly women's healthcare, where the former Minister made a lot of positive changes so I want to start with that.

The Minister mentioned bank holidays, and rightly so. We see a spike on bank holidays in terms of the numbers of patients on hospital trolleys or not admitted to a bed in a timely fashion. The difficulty is it is not just on bank holidays; it is every day of every week of every month. According to the Irish Nurses and Midwives Organisation, we have this continuous clash between the figures produced by the HSE and the numbers used by the INMO. However, last year, there were 122,186 patients admitted to a hospital without a bed. In fact, January of this year was the worst-performing month in the history of the State with more than 13,000 people again treated inappropriately without being admitted to a bed in our hospitals right across the State. Most of those people were not there on bank holiday weekends. I got an email from a constituent called Mary. I want to give her example because the Minister asked for examples. This was not a bank holiday. It was today. She said she was waiting since July for an amputation following an infection and complications from a previous surgery. It was causing her great difficulty as she is the main carer for her daughter who has Down's syndrome and she is restricted because of her injury. She turned up today at the hospital only to find out that not only her surgery but that of many others was cancelled because of other problems in the hospital. This is causing her great stress. Her daughter is due for treatment in the hospital next week and now she is worried her daughter's treatment will also be cancelled.

There were 20,000 more hospital cancellations last year than there were the previous year. Therefore, while the Minister can talk about the number of long waiters coming down - and I celebrate the fact that they are - we still have far too many problems in our healthcare system, including cancellations and overcrowding. When we see a surge in emergency departments, one of the few options open to hospital managers is to cancel elective procedures and that then creates havoc with our health services generally.

It is right that we should always aim to ensure that people can live longer and live healthier lives. The first thing we need to do is to make sure that people can be treated and live in their homes. The Minister mentioned that in her speech. She did not mention was the statutory home care scheme that was in the last programme for Government and it seems is in this programme for Government, though the Minister made no mention of whether she would deliver it. We were promised it and promised it and yet no movement was made by the previous Government. As Teachtaí Dála, we all receive representations all the time from people who are looking for intensive home care packages and they are not there. The Minister spoke about having the senior decision-makers, as she put it, working in our hospitals during bank holiday weekends to speed up discharges but if she talks to hospital managers they will tell you that part of the problem is that people cannot be discharged because the step-down beds, the recovery beds, the convalescent beds or the home care options are simply not there. If we only focus on one element of the problem, we will not solve it. It needs a lot of different solutions - not just want is happening in the hospital but what is happening outside of the hospital.

We also have a real crisis in mental health. I know she is not directly responsible for mental health but it was not overtly mentioned in the Minister's speech. We have a real problem with CAMHS, which is under-resourced. There was a promise of 12 dual-diagnosis teams to be established in this State. Only two are up and running and even those two teams are not fully operational. All of these are issues under the Government's control, and now under the Minister's, which need to be dealt with.

I turn to the programme for Government. The Minister outlined a long list of commitments she wants to deliver over the next five years. We will see what progress can be made. She talks about 4,000 to 4,500 new and refurbished beds. What we need are timeframes. How many of them are new? How many of them are refurbished? Is the capital funding there to make all of that happen? She talks about providing more community beds. I raised this publicly a number of times. There is no number. Is it one, 50 or 100? Any of us could come into this Chamber and say we are going to do more, have more beds and more staff. If we did that and produced a plan that just called for more of everything, we would laughed out of it. The Minister has to have specifics in this regard. What does she mean by more community beds? She mentions the four elective hospitals. We have been hearing about these elective hospitals for years and years and they are still at the starting gate. They are crucial. It is reform with a big R. If we separate scheduled from unscheduled care, that is the best way to actually reduce waiting lists, particularly those in the elective space which are the big problem. I refer to orthopaedics and many other areas.

The Minister also spoke about the new national children's hospital. It is interesting that we hear a great deal about this June deadline. That is the completion date given by the contractor. I was a member of the Oireachtas health committee when the members of the National Paediatric Hospital Development Board came before the committee last October and told us they had no confidence that the contractor would meet that date. They told us that none of the 4,000 rooms or spaces in the hospital were finished to the appropriate standard. They told us the contractor was not adequately resourcing the project and they had grave doubts whether any of these issues could be resolved. I do not know what happened over the past few months, but now it seems everybody is saying this June deadline will be met. The question is if it will be met. I wonder because we have had 13 or 14 deadlines, which, as the Minister knows, have come and gone. She will probably have seen a letter that was sent to her as well from a number of paediatric consultants working in Children's Health Ireland. They referred to the lack of consultant posts and, essentially, said that if we do not see more capacity in this space, the hospital will not even be safely staffed from the perspective of the consultants from day one. All these are important issues if people are to have confidence that the national children's hospital will be opened on time and treating children as quickly as possible.

I wish the Minister well. I want to see progress being made. I want to see waiting times reducing. I do not want to see hospital appointment cancellations. I do not want to see children with scoliosis or spina bifida waiting for care.

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