Dáil debates

Wednesday, 1 February 2017

Priority Questions

Health Services Funding

2:15 pm

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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30. To ask the Minister for Health if, in view of the record number of acutely ill persons waiting on trolleys in emergency departments in January 2017 and the threat of strike action by nurses due to unsafe staffing levels, he will allocate emergency funding of €1.2 billion to urgently address the deficits in hospital beds, medical staffing and primary care services in the health service; and if he will make a statement on the matter. [4857/17]

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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I ask the Minister for Health whether, given the record number of acutely ill people who are waiting on trolleys in emergency departments in January this year and the threat of strike action by nurses due to unsafe staffing levels, he will allocate emergency funding of €1.2 million to address this problem urgently.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I thank the Deputy for the question. On budget day 2017, the Oireachtas approved gross expenditure of €14.606 billion for the health services, which is the highest level ever, demonstrating the Government’s commitment to investing the gains from a recovering economy in a better health service. The provision for this year represents a 3.5% increase on the final projected 2016 outturn. The Health Vote for 2017 has increased by 9.4% over the 2015 outturn, recognising the Government’s commitment to providing a health service that seeks to improve the health and wellbeing of the people.

The additional funding secured will continue to support the health service to provide the optimum level of safe services for patients within the budgetary limits. However, there are still real fiscal challenges facing the health service. Health care demands continue to rise due to our growing and aging population, there is an increase in the incidence of chronic conditions and advances in medical technologies and treatments which are good for patients but come at a cost in terms of having a limited budget.

Accordingly, we must continue to focus on the effective use of limited resources and the management of funding made available by the Oireachtas. In the past, the health service did not manage its budget and the first call on any extra resources went into a black hole. We have managed to avoid that this year and all of the additional resources can be used for additional health services and demographic pressures.

On 20 October 2016, the HSE was notified of its maximum level of expenditure for 2017. The level of health services to be provided within this available funding is set out in the HSE’s 2017 national service plan. The allocation of additional funding to the health services is a matter for the Government and the Oireachtas, operating within the EU fiscal rules. It is fair to say that the Government used all of the fiscal space available to it, and health received a substantial increase in its budget as part of this.

This Government will continue to prioritise the needs of those requiring health services in determining the annual budget. This is evidenced by the provision of an additional €977 million in this year's allocation to the HSE compared to the original allocation for 2016. Perhaps in my response to the Deputy's follow-up question I will make the point that the level of funding is not the sole factor; we also have to consider how the money is spent within the health service.

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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This is not a perennial problem; it runs much deeper than the yearly crisis that is generated. I want to differentiate between the political and the personal, because that is important. I am sure the Minister and everybody else in the House does not want to see anybody on a trolley, but it happens. At one stage this year, 600 people were on trolleys. They are ordinary people who paid taxes and try to live a good life, but are sick and sought help from the Irish health service. It is an embarrassment, as a citizen of the country, to see people on trolleys waiting for basic health services.

I said I do not want to be personal, but rather political. The Fine Gael Party has been in government for the past six years and has had two previous Ministers for Health who failed abjectly. The Minister should be embarrassed to be a part of Fine Gael, a party that has let down many people in the country who paid tax and yet have to suffer.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I am very proud to be a member of Fine Gael. In my engagement in the House, I always try to not be partisan because I am conscious that many different people from all parties have stood in this position as Minister for Health over the past number of decades - not yet from Deputy Kenny's grouping but that may happen - and have faced similar challenges to those that I face this January and February. I can engage in political partisan talk, and I am well able to do so, but it will not serve the substantive issue.

Health services in Ireland, the UK and Northern Ireland, as well as many other countries, have faced significant pressures during the winter period. We need to have a discussion on what we will do to make sure that we do not see the same challenges next winter and subsequent winters. I am convinced that if we keep doing the same things, namely, increasing the level of funding and the Minister of the day announcing more budgets, we will not break the cycle. Solving this problem will involve doing something different.

That is why I am a great believer in the work of the Oireachtas committee to come up with a ten-year strategy that removes party politics from the issue and provides a level of certainty. That is why we need a bed capacity review. How many beds do we need? We have not built a new hospital in this country since 1998. If I told the Deputy that we have not built any new schools since 1998 he would not be surprised that there were not sufficient places for schoolchildren. We need to determine what to do differently in terms of bed capacity, recruitment and so on.

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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I hope next year and the year after the Minister will be able to say there are no patients waiting on trolleys. The situation is very serious. Let us get down to the facts. This problem is also the fault of Fianna Fáil. Some 1,600 beds have been taken out of the Irish health service over the past nine years. Of course that would result in a crisis.

Worse than that is the morale of the accident and emergency staff, who are the best trained and motivated staff in the European Union. They are well qualified, but are demoralised by cuts in the health service and seeing people who could be their brothers and sisters on trolleys.

The Minister has the power to solve this issue. It is not rocket science. There is a solution to every problem. The solution to this problem is to provide more beds. The Minister should stake his claim and say there will be no trolleys on corridors in the next 18 months. If he can do that, he will go down in history.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I appreciate the Deputy's bona fides and we share a desire to fix this issue. I agree that the staff in our health service are incredible and are doing incredible work, and have done so over the past number of years with fewer colleagues standing beside them on the wards. That is now changing.

Since I became Minister for Health, we have increased the health budget not once but twice. We have put in place dedicated funding for waiting list initiatives. We are recruiting more staff. We are not cutting the health service budget.

I have to be honest with the Deputy. I have been in the job for nearly nine months. It is about how the money is spent. If we think that the answer is to believe that everybody needs to go to an acute hospital for every service, that we cannot do more in primary care and every time a new Minister for Health comes into office he or she should start changing the plan the health service will not work.

The health service needs a ten-year plan. That is why we have a cross-party committee, on which the Deputy's colleague, Deputy Barry, sits. It is due to report in April. That is why I am committed to working with the committee to implement the plan so we can collectively say to the citizens of this country that we have a roadmap for the health service, it will take ten years to get there, here are the milestones and here is how we will pay for it.