Trevor Ó Clochartaigh (Sinn Fein) | Oireachtas source

Cuirim céad fáilte roimh an Aire. B'fhéidir gur é seo an t-am deireannach a bheidh muid ag labhairt leis sa ról ina bhfuil sé. Is lá stairiúil sa mhéid sin é sin. It is essentially a technicality whether funding for health services is voted in separate HSE and Department of Health Votes, as has been the case up to now, or in one Vote, as will be the case under this Bill. What matters is that there is sufficient funding and that this funding is used to best effect. On both counts, this Government, like its predecessors, is failing. By the end of 2014, under the HSE service plan, almost €4 billion will have been taken out of our public health services since 2008. In terms of staff numbers, a further 2,600 whole-time equivalents are to go in 2014 on top of the 12,500 that have gone since 2007. Under the HSE divisional plans, hospitals are expected not only to function as last year but to perform better with a reduction of €200 million in their budgets. Acute hospitals that are already struggling face an average reduction of 4% in their funding. By the HSE's own admission, front-line care is being affected, with a projected drop of 25,000 in the number of day cases and a reduction of 3,000 in the number of inpatient treatments during 2014.

An example of how unrealistic these plans are is the target of reducing delayed discharge from acute hospitals by 4%. The allocation for nursing home beds has been reduced, which will mean many more older people spending longer in scarce hospital beds, because there are insufficient nursing home places for those requiring residential care. It is something I have noted at the briefings we get as Oireachtas Members from hospital groups and primary care representatives. There always seems to be a lack of joined-up thinking. Issues that could be dealt with in a primary care setting are often kicked to touch because of budgetary constraints and we end up having to pay far more money in the acute hospital setting to pick up the pieces. The patient is the person who suffers.

The report of the Mental Health Commission shows that only 44% of psychiatric hospitals and mental health facilities are compliant with staffing level regulations. It is ironic that we are here debating this issue when nurses from the Psychiatric Nurses' Association are protesting outside the hospital in Galway about the lack of psychiatric nurses there. It was predicted after the closure of St. Brigid's Hospital in Ballinasloe that additional pressure would be put on University College Hospital Galway. They are very concerned that while there should be a cohort of 50 nurses in that unit, only nine are there on a regular basis. They are very concerned about the level of care they are able to give under those circumstances. Certainly, it leaves much to be desired. Such policies are endangering the delivery of confident and responsive community-based services, as envisaged in A Vision for Change, which is the Government's mental health strategy. It is also of huge concern that the Mental Health Commission reports that children are still being admitted to adult units. A total of 91, or 22.3%, of all child admissions in 2013 were to adult units.

This Bill is essentially a technical piece of legislation as it provides for the ending of the HSE's separate Vote in the budget. In future, it is be funded through the Vote for the Office for the Minister for Health. However, in light of what I have pointed out regarding budget underfunding in 2013, the resulting necessary Supplementary Estimates and the underfunding in 2014, section 10 of the Bill is a cause for concern. It would mean an overspend in one year would be carried over to the following year as a charge on the HSE budget. It is relevant that Senator MacSharry raised the oversight issues that came to light in the West/North West Hospitals Group. It is very hard to trust the Department of Health on issues such as this when we see that there was an issue with the procurement process in respect of the review of maternity services in that hospital group. It came to light that the chairman of the group had to resign as a result of that. If the Minister leaves office, will he make available before then the HSE report on that procurement process, which I know related to that particular review?