Michael Collins (Cork South-West, Independent Ireland Party)

Today, we are presented with the Health (Amendment) Bill 2025. On the surface, the Bill promises reform, but let us be clear - this is not reform, but bureaucracy dressed up as progress. The Bill does not fix our broken health system. It merely rearranges the furniture in a house that is already on fire. It tinkers with the governance structures while ignoring the real crisis, which is the daily struggle of patients and front-line workers. The people do not need more layers of reporting or internal reviews but functioning hospitals, nurses who are empowered and not overworked, GPs who are supported and not sidelined, and care that is accessible, timely and humane.

This morning, my office got a call from an 89-year-old lady who was caring for her 55-year-old son who had a disability. She is unable to get home help. She had it until a number of weeks ago but the HSE has set up a pod system for home help in the Bandon area. The constituent is outside the pod system and, therefore, has no home help. It has been put out to private providers, but to date that has been unsuccessful. This lady is saving the State a lot of money by caring for her 55-year-old son yet the State is unable to provide her with assistance. She is 89 years of age. There is a severe lack of home helps in west Cork. A new computer system is being set up and the home helps are being expected to go online instead of doing what they are great at, which is looking after the people at home. A lot of them are retiring and walking away from the whole thing because it has got too complicated. It is obvious it is not working on the ground.

We have another family, which has a six-year-old boy who has been diagnosed with undescended testes. He has been on the waiting list to be seen in Cork University Hospital even though he is classed as urgent. He is in a lot of pain, which is causing him to fall quite a lot. He is not able to go out and play with his friends and this is causing him a lot of anxiety. His mother received a letter today asking if she wanted her son to remain on the waiting list.

We have a constituent who is in his mid-50s and caring for his elderly parents at home. They both have dementia. Recently, his mother was in hospital and, upon discharge, she required a wheelchair and commode at home. Her son made over 40 phone calls to the HSE about getting the equipment he was told would be supplied upon discharge. Eventually, he had to go to the HSE stores department and get the equipment. Communication with the HSE is extremely poor.

Friday saw the publication of the abortion figures for 2024. There were 10,852 abortions in Ireland, which is up 63% on 2019. The promise made during the 2018 referendum that abortion would be safe, legal and rare has well and truly been broken. The figure of 10,852 is the highest number of abortions we have ever seen. In my county of Cork, 957 babies lost their lives by abortion last year. The Government must think seriously about offering women with unplanned pregnancies greater supports and clearly-signposted alternatives to abortion. No woman should ever feel she has no option but to have an abortion.

True reform means more hospital beds. It means better pay and conditions for our healthcare staff. It means supporting carers who give so much and receive so little. It means a mental health strategy that does not just exist on paper and reaches into homes, schools and communities. Our vision is clear. It is oversight, transparency and fairness with policies rooted not in spin, but in service to patients, workers and families. Over the last number of weeks, I have raised a lot of serious issues here and I find there is very little progress on them. I am writing to the Department of Health and the Taoiseach and I am raising them with the Taoiseach. One is the situation we have with the nursing home in Bantry. There is an issue between a proposed purchaser, the receiver and HIQA. The bottom line is the people who are suffering most are the ones who are worried their nursing home will be closed down on them. There has been an enforcement order slapped on it by HIQA, giving two weeks, which I think will be up this weekend, for the receiver to appeal. In the meantime, there is an opportunity because the hospital has been brought up to a perfect standard. The staff there are doing their best to bring the hospital up to standard.

There is a possibility of 17 more beds for patients and that provision is desperately needed. I know of people in the Bantry catchment area - in Drimoleague and all around that area - who are being sent to nursing homes as far away as Kenmare. That causes awful stress for families. I put a question to the Minister of State, Deputy O'Donnell, recently, on which I am not sure he ever got back to me, to find out exactly what was wrong and asking that he intervene in some way or other to get this across the line. It is down to a paperwork exercise. There is no longer any issue with the nursing home. There is another one in Conna near Fermoy.

I also raised the issue of Perrott House. I hate to use the word "abuse" but abuse can come in different forms. We have seen what goes on in some nursing homes. Families have been told Perrott House has to be done up, and there is no issue with that, but they have never been told where their loved ones will go. Last week, a family member of mine asked me about this. He is delighted I am raising it continuously in the Dáil. Families feel they are not getting adequate support or advice as to what exactly is happening with places like Perrott House. They are finding out information bit by bit and they are worried and looking over their shoulders.

An issue that has been raised by several Deputies is the ambulance service. I have been fighting a long time for a better service. I know of cases where people have waited three, four, five or six hours for an ambulance. That is outrageous and bordering on a disaster situation for many people. I have sometimes advised people that the best thing to do is to take a chance on taking the person by car to get treatment. I spoke a year ago of someone having to wait eight hours in Bandon. It is not good enough. We need an ambulance service that people feel they can trust. People living in west Cork might have an ambulance coming from another county. How is an ambulance brought from another county into the deep end of west Cork to pick up somebody who is gravely ill?

It would be wrong of me to stand here and fault community hospitals. They are the gold stars of our health service. Anybody with a loved one in a community hospital, or who is familiar with the local community hospital, knows the excellent service these facilities provide. In my area, we have lots of community hospitals, including in Schull, Castletownbere, Dunmanway, Bandon and Kinsale. They are top-class facilities. However, the population is ageing and there is no extra bed in them, nor any extra beds planned over the coming years. How do we plan to tackle the crisis facing us in the next five, ten or 15 years? We have a growing population of elderly people who will need community hospital beds. Hospitals that had 20 or 30 beds in the 1960s and 1970s still have the same number now and the same number planned into the future. The Minister must take note of that. It is not a good situation.

I have spoken to a lot of nursing home operators about how they have to keep their facilities up to standard. The community hospitals at least have the State behind them in ensuring they are up to standard. Nursing homes have no such State backing and those costs must come out of the owners' coffers. In some cases, that may lead to the closure of nursing homes. It is a very serious concern. There must be supports to bridge the gap. The Minister has met Tadhg Daly of Nursing Homes Ireland several times, as have we. He has advised on the direction things need to go. They are not moving quickly enough. I have spoken to nursing home operators who are seriously concerned they will not be able to keep their doors open. In most cases, they are having to pass increased costs on to patients. That is unfair on patients and their loved ones.

We have fantastic medical care centres in a lot of places in the country. My worry is that, while they have 20 or 25 rooms, only three or four of those are in operation. Why is there no dental service back in operation in places like Schull, Skibbereen, Dunmanway and Castletownbere? We have fantastic medical centres in Schull and Castletownbere but no dental service. It was there when I was growing up in the seventies. Surely be to God it should be there in 2025. The dental service in Bantry is in operation only three days a week. Clonakilty has a five-days-a-week service and is now seeing to the whole of west Cork, with which it cannot cope. At one time, first, third and sixth class children were looked after by the service. Now, it is only sixth class pupils who get that service.

There are areas where services need to be improved and I ask the Minister to look at them. In the case of Perrott House and the nursing home in Bantry, people are finding themselves in crisis situations right now. They would appreciate if some help were given by the Minister.

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