Mattie McGrath (Tipperary South, Independent)

Ar an gcéad dul síos, gabhaim buíochas leis an gCeann Comhairle for selecting this Topical Issue, albeit to be taken after midnight.

There is a concerning issue affecting the lives and health of many vulnerable people across County Tipperary, namely, the unacceptable and short-sighted cuts to hospital patient transport services. For many in rural areas of Tipperary, especially the elderly, the sick and those on low incomes, access to hospital appointments in places such as Clonmel, Limerick, Cork, Waterford and Dublin depends entirely on the patient transport services provided by the HSE or voluntary organisations, such as the Red Cross, Civil Defence and the Order of Malta, which I salute for the work they do. These are not luxury services; they are essential lifelines. I have been contacted by families, carers and community groups who are at breaking point. They are being told that transport is no longer available, services are being rationalised - that lovely word - and, in some cases, patients must find alternative arrangements. What alternatives do they have in rural parishes?

Public transport is limited or non-existent in much of Tipperary. Many of those patients are already frail, wheelchair users or recovering from major surgeries. They cannot drive themselves. Their family members may be working or living abroad. The result is missed appointments, delayed treatments and worsening conditions. Ultimately, this leads to pressure being piled back on our hospitals through avoidable admissions to accident and emergency departments.

In one case, a man waited four years - 48 months - for an appointment. He has no family. His neighbour who used to bring him to his appointments passed away a month ago and he had no one else to transport him to Cork. He was too frail to use public transport, as it was non-existent in the first place. A taxi would have cost him €120; half of his pension would have been gone in one appointment. It is such a shocking situation.

In another case, a woman with a paraplegic daughter required an ambulance transfer. This woman literally had no other option. She could not just get a neighbour to drive her. In the end, she was forced to beg a voluntary organisation to transfer her and her daughter to her daughter's appointment, which did happen thanks to the volunteers and the voluntary ambulance.

This is not a question of convenience. This is about dignity, equality of access and the right to timely medical care regardless of a person's address or income. Who made the decision to unilaterally cut this without any engagement? Why were the cuts made with no public consultation, no Dáil debate and no local agreement or engagement? Where is the assessment of the human cost to this? Will the Minister of State commit to immediately reviewing the criteria for access to patient transport services in Tipperary with a view to restoring full service? How can faceless bureaucrats decide this?

When I was elected to this House in 2007, the budget for the HSE was approximately €7 billion. Now, it is €24 billion and growing every year. How come it is affecting the most vulnerable? Earlier, the House spent five hours - Cara Darmody was in the Gallery with her dad - debating people's access to assessments of need and how the HSE was breaking the law hourly by not providing those assessments. Why are we allowing this cabal in the HSE to run amok, do what it likes, neglect people and flout the laws?

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