David Cullinane (Sinn Fein) | Oireachtas source

I welcome the Minister to the House. It is fair to say his honeymoon period as Minister for Health has come to an end, given the very high outpatient waiting lists we have and the many people on hospital trolleys day in and day out in this State. It seems to be a particular problem in some hospitals and the issue must be resolved. The first time he came to the Seanad to engage with us on these issues as Minister for Health I indicated to him that he had the opportunity to be a reforming Minister. His predecessor talked tough about what he would do but he did not deliver. The current Minister has said he would deliver and he seemed to have a vision of where he wanted to go with health care, even if meant tearing up the commitments of the previous Ministers and even those of the Government. I have a different view to the Minister on how health care should be delivered.

When the national service plan was published, 50,000 patients were waiting longer than one year to see a consultant as an outpatient. I could judge the work of the Minister by my benchmark or that which is set by others but the Government has set a benchmark on these figures. It indicated that adult outpatients would wait no longer than 12 months to see a consultant, and that goal has not been achieved. I can provide figures from University Hospital Waterford, where 4,176 patients at the end of last year were waiting longer than 12 months for an appointment. Some departments in that hospital - I am sure it is the same in other hospitals as well - are real pressure points. There are more than 470 people waiting for an outpatient appointment in dermatology, 426 people waiting for general medicine, 627 people waiting for general surgery and 127 people waiting for a pain specialist. There are 356 people waiting more than a year for an ophthalmology appointment and 1,100 people waiting more than a year for an orthopaedic procedure. It is a big problem in the Waterford hospital, which has a lack of capacity.

I specifically raised a question with the Minister on the last occasion he was here but it was not answered. An arrangement was put in place whereby patients from the south east would travel to Cappagh Hospital in Dublin to be treated. Some people travelled for this and a full suite of care was to be carried out. The arrangement was then cancelled and no real reason was given for that. Some people were seen by a doctor but they never got any treatment. All the files were returned to Waterford and waiting times were increased. This is not even to mention the problem we have in the hospital in hiring consultants. I can only consider my experience in the part of the country I live in. We have big problems with health care there which must be overcome.

I will deal with the fair deal scheme in a moment. In Waterford and the south east in general we were promised a 100-bed community nursing unit or geriatric care facility. This is mentioned in the service plan but there is no mention of whether it is at a design stage, whether planning permission will be sought, if funding has been given and when the facility will be provided. HIQA is already involved in discussions with St. Patrick's Hospital in Waterford, the only existing geriatric care facility in Waterford. A unit has been closed in that facility because HIQA felt it was not up to standard. There are very real concerns about the consequences if the new unit is not built, and it should be prioritised.

My colleague in the Dáil, Deputy Ó Caoláin, has flagged that the fair deal scheme continues to be under-resourced, and the plan has only offered the already announced €25 million to assist with delayed discharges. Of most importance, it did not provide the €100 million requested by the HSE to deal with the problem. The failure by the Minister to provide this or otherwise properly address the number of elderly patients in acute hospital beds has led to the crisis of overcrowding in accident and emergency departments and the horror stories we have heard over the past few weeks. The minor increase in the number of doctors and nurses set out in the plan is undoubtedly necessary but the numbers mentioned only go a very small way towards addressing some of the more savage cuts in staff numbers in recent years.

There is much discussion in the public, political and media domain about wage increases and tax cuts. Auction politics for the next election are well under way. If we are to talk about tax cuts, we must also consider from where the money will come if we must invest in public services and ensure we do not have people on hospital trolleys. The Minister's party cut the top rate of tax by 1% in the last budget but would that money not have been better spent in ensuring people have access to proper health care, as that has an impact on the most vulnerable and disadvantaged people in this State? This is about political priorities and choices. We must make tough decisions but, unfortunately, the kind of decisions made by the Government are not fair or equitable. If we are to have a discussion about how we spend any extra money around the place, I hope that investing in public services and rebuilding the services that were battered after seven years of austerity will also be front and centre. The health service must be one of those areas.

Accident and emergency departments will be equipped to deal with people experiencing a mental health crisis on weekends as well as Monday to Friday. However, we have seen before that services can be promised but money might not be drawn down. We must keep a close eye to ensure services materialise and are supported. Much more needs to be done. I would always wish the Minister well in his job, as it is one of the most important portfolios of any Minister. I am sure he recognises that and his privileged position. He can help patients and sort out the problems in our health service while imposing his own vision. Nevertheless, we must see much more action and the Minister must get much more support from the Government and Opposition in doing the job he must do.