Brendan Ryan (Labour)

I move:

That Seanad Éireann,

—alarmed at the growing crisis in accident and emergency services throughout the State,

—noting that, by the admission of the Minister for Health and Children, over €400 million worth of new hospital facilities are lying idle because of Government failure to provide funding for equipment and staffing and

—noting that sufficient funds are available to the Government to bring all the unused facilities into operation,

condemns this scandalous dereliction of duty by the Government and demands that the Minister for Health and Children immediately provides sufficient resources to bring all the unused hospital facilities into use.

No Member can debate the health service without mentioning the crisis in accident and emergency services. This motion addresses the extraordinary situation where, in the words of the Minister for Health and Children, approximately €500 million worth of capital investment in hospitals and health facilities is lying idle because the Government cannot organise the funding to run those very facilities. I am grateful to the authors of the Government amendment to this motion. Among their glowing praise for the Government's achievements, the substantial capital investment of €1.7 billion in health infrastructure spent between 2000 and 2003 is included. The equivalent of 25% of the capital expenditure is now lying idle.

I am not sure whether this debate should focus on the health services or incompetence. The incompetence spins off into the most appalling consequences for those who are sick and need hospital services. It is difficult to know how many cities and towns this spin-off affects. In Dublin city, a €100 million hospital wing is empty. In Cork city, a much touted and sung and danced about accident and emergency service is unused. In Clonmel, which I visited on my recent electoral adventures, a €30 million hospital wing is also unused. It is the same in Mayo, Letterkenny and many other places. Each of these cases impacts on individuals' health, security and sense of well-being. Each damages people's belief that they are safe if they fall ill. However, it is worse in terms of what it says about the Government's incompetence. It suggests that it cannot plan or organise, leaving gaps in the hope that in the future something will turn up. A health service based on such a premise will only turn up pain, suffering and disaster for people.

The Government has decided that it will not make the necessary money available to bring the health service up to a proper standard. Recently, my secretary, on my behalf, sent out an e-mail query on hospital waiting lists to EU member state embassies in Dublin. The German Embassy's reply was prompt and Germanic, stating that there are no hospital waiting lists in Germany. The Austrian reply stated that there are only waiting lists for orthopaedic and ophthalmology services. Yet, it is part of this Government's mythology that waiting lists are inevitable. The Government has actually redefined the abolition of waiting lists as having no one waiting for more than three months. Ireland has defined the lower end of its expectations at the upper end of public patients in the rest of the EU.

The Government believes that only going some of the way is sufficient. It boasts of spending €1.7 billion on capital investment, yet a quarter of that investment remains unused. Some of it is even used for offices or to keep private security firms in business as they prevent the facilities from being vandalised. In south Tipperary, a person from Clonmel at the most critical part of an illness that requires surgical care has to be moved to Cashel, a distance of 15 miles. In a good hospital at such a time, moving the person from one ward to another would require proper medical supervision.

This occurs because someone in Government decided the money will not be spent. There are two possible reasons for this decision. The first is incompetence, which I would almost prefer to believe because incompetent people can be shamed into a modicum of competence. Underlying this is an indifference to the human suffering it causes. The second reason is the reactionary position of the Department of Finance. Today, the Minister for Finance, Deputy McCreevy, re-articulated it, in classically flamboyant fashion, when he claimed every view except his on how to run the economy is wrong. He continued that if he was not Minister, the financial world would take fright and refuse to invest in Ireland. When a Minister for Finance begins to talk in those terms, it is time to get rid of him. Once anyone in a position of power believes that he or she is indispensable, it is time to remove him or her. The fundamental problem with the Minister, his Department and the Government, which is dominated by the Minister and the ideology he shares with the minority party in Government is that it is dangerously hurtful to ordinary people. It is also wrong, because wrong figures have been used.

The Government took comfort from an analysis in the Irish Banking Review by an economist who because he did not understand health spending figures, gave a completely wrong perspective on Ireland's comparative performance on health expenditure. He suggested that we were near the top of the league and that the problem was therefore one of incompetent management, an argument the Department of Finance loves, which is why it will not pay out the extra expenditure to open these facilities. It prefers to believe that the problem is inefficient use of sufficient resources. That is the view of the Minister for Finance and his Department and it has prevailed over the views of every other Department and over the Taoiseach. The result is that in terms of capital costs, a quarter of the facilities provided by the Government over the years 2002 to 2003 lie idle.

The trouble with the view taken by the Department of Finance is that it is factually wrong. The OECD health data of 2004, including tables and charts from a news release issued on 3 June 2004, less than four weeks ago, show that Irish health expenditure as a percentage of gross domestic product stands at 7.3%. The countries spending less are Turkey, Mexico, Poland, Korea, Slovakia and Luxembourg. All of the other OECD countries spend a greater proportion of their GDP on health than we do. A civilised country like Germany, where there are no hospital waiting lists, spends 10.9% of its GDP on health care. The figure for the United States is 14.6%. If ever there was an argument against the use of the private market as a way of organising health care, the United States experience of having the highest percentage of GDP expenditure and the highest growth rate in expansion of costs over the past few years provides it.

We are seventh from the bottom of the OECD league in health care expenditure. The fundamental problem is that we will not spend sufficient money. One can have all the ideological twaddle one wants from the Department of Finance, the Progressive Democrats and that party's Minister for Finance, but while there are many problems with the Irish health service, the fundamental one is that it is underfunded to a scandalous degree.

The amendment lists all the alleged glorious achievements of the Government. As a percentage of GDP, in the five years of the previous Government, from 1997 to 2002, our expenditure on health increased by less than 1%, perhaps the lowest rise in the OECD. What has happened in the case of the €450 million of capital expenditure is that ideology has clashed with reality. When that happens, when one has the rigid ideology that has driven this Government, and has driven Fianna Fáil into its worst electoral disaster in 80 years, facts get lost, reality is denied and one ends up with the crazy situation of hospitals worth close to €500 million lying idle because trivial sums will not be spent on them.