Maire Devine (Sinn Fein) | Oireachtas source

It is Devine.

Quelle surprisewith Fianna Fáil's amendment. We are used to it at this stage. It is a good way for it to keep sweet with both its friends and foes.

Our comhliosta proposal would see immediate improvements for those people on long-term hospital waiting lists. It is an unfortunate fact that if people access the public health system, they will more than likely feature on two lists which are often referred to in this Chamber. If they go to accident and emergency, they will likely be a part of the trolley figures released daily, not by the Government but by the Irish Nurses and Midwives Organisation. It has been eventually conceded by the Government that the INMO's figures are correct. Today, the total number of patients on trolleys is 425. It has reached 600 at different times and not just because of the influenza virus.

If these patients are lucky and get a bed and an assessment, they may be referred to a specialist or a consultant who will then prescribe a necessary and often life-saving procedure. It is then they will feature on the National Treatment Purchase Fund, NTPF, published waiting lists.

While all this bureaucracy is ticking along, people with suspected serious conditions are left to worry as the weeks pass by if their condition is worsening and if the passing time is reducing their chances of a successful recovery. As the Minister knows, when people become ill, their job is at risk, their finances decrease and their well-being is affected. They are left to languish at home with nothing to do, only worry when their procedure will happen, whether it will be successful or whether they will expire in the meantime.

An example of this process is the amount of time people spend waiting for mammograms. Early diagnosis is vital and I commend the successful BreastCheck programme. A friend of mine who is under 50 was referred by her GP for a lump on her breast. She was told by St. James's Hospital that it will be 26 weeks before she is seen. I have had someone table a parliamentary question to find out why there is such a long waiting list for such a serious illness.

Sinn Féin's system would have patients enter the waiting list at least at the point of referral for treatment by a consultant specialist. As the budget for comhliosta would grow, we would want to see the patient enter the system at the point of referral by a GP. The system would be freely accessible to patients online where they could monitor their position on the list in real time. After 75% of the target time has elapsed, they will have the option of using a voucher to seek treatment in the private health care sector or from a public hospital if it is not experiencing the same pressure on its waiting lists.

More resources and staff are needed to meet increasing needs. However, making improvements is not just about money. Changes mean senior clinicians should admit and discharge patients. It means making the health system attractive to recruit and retain high-calibre staff. It requires more and better access to diagnostics and treatment outside of hospitals, often in primary care centres, delivered by GPs and nurses. This involves resourcing primary care. It means doing what is currently not being done.

Over a decade of pouring hundreds of millions of euro into the NTPF is proof that it does not address the underlying causes of the long waiting times for public patients in the first place. This week's revelations show the waiting times for public patients, as articulated by the NTPF, have not been accurate in the first place.

The issue of mental health waiting lists has barely been touched on in this debate. My colleague, Deputy Pat Buckley, recently received information from the Health Service Executive, HSE, regarding waiting lists for mental health care for adolescents in the southern region. The figures were shocking. Compared with the rest of the country, they are 50% higher in that region and we need to find out why. We know of the anguish of parents and young adolescents having to wait for a consultation or counselling for up to 20 weeks.In the meantime, most of them deteriorate mentally and feel unsupported, as do their parents.

The figures shine a light on the gaps in mental health services and supports for children, including staff shortages in child and adolescent mental health services. Mental health is an area in which successive Governments have struggled to provide an adequate level of service. This is an issue that Sinn Féin has highlighted continually in the Dáil through parliamentary questions and through representations to the HSE. In our Better4Health document launched last year, Sinn Féin put forward ten proposals to ensure mental health care is prioritised. A 24-7 service was voted down, not only by the Government side but also by our friends in Fianna Fáil.

Access to mental health services for children and young people is clearly severely restricted when one considers the current waiting lists. A cursory glance at the figures shows that mental health care for this cohort is not being prioritised as it should be, not just because of the existing waiting lists but also because of the staffing levels in the community.

Our comhliosta proposal formed part of the Better4Health document which we launched last year. Senator Colm Burke has not taken an opportunity to look at it. When my colleague, Deputy Louise O'Reilly, pressed the Minister or the HSE on the need for a new single integrated hospital waiting list management system, she was met with refrains that it is one option presented as part of a digital package solution, but we are no clearer on the Minister's intention to bring this forward. The HSE argues, according to documents, that €1 million would be sufficient to advance this. The Minister would be better off investing public funds in this type of new system and the digital solutions required to modernise our health service rather than relying on the questionable National Treatment Purchase Fund, NTPF, figures which have demonstrated that fund's inability to be transparent and its management of waiting list figures. Investment in developing capacity in the public health system would be more beneficial in the long term.

The Minister has our proposal in writing and he refused to meet us on several occasions. In e-mails dated 17 and 30 August and 16 September last year, the Minister's office fobbed us off with excuses on waiting list initiatives and when we requested to meet to discuss our proposal.

There is a Committee on the Future of Healthcare, with which Senator Colm Burke has close contact and on which he has a heartfelt need to be, but it has become clear that the five point plan has failed in this regard. The Minister should actively look at the solutions we have presented to him. The Minister should also make the process more transparent. What are the digital package solutions the Minister has used as a stock response to many of my party's suggestions? What progress is the Minister making on this? What investment is needed? Can we have an update on this? We have not received one to date. The matter is not being given the attention it deserves.