Maire Devine (Sinn Fein) | Oireachtas source

I wish to share time with Senator Mac Lochlainn.

Does the Minister realise he has been gagged? I need to bring it up again. The Minister has been gagged by this House, in particular, Fine Gael and Fianna Fáil Senator. An hour ago, supported by my colleagues and Senator Kevin Humphreys, I tried to get the Minister to answer as to why no parents were given a voice at the table for the national steering group on children with complex medical needs and the development of policy but, unfortunately, the Minister has been gagged. The Leader stated he did not want to play political football with this. He has actually done that, as have Fianna Fáil Senators who went against their own sense of what is right in allowing participation by parents, who are the experts on this. The Minister does not have to answer it. I will resubmit the amendment to the Order of Business on Tuesday next but I am so unclear as to why it was not allowed. I still do not know. That is probably due to my naivety but also the political football that is being played out in this Chamber by Fianna Fáil and Fine Gael Senators. Shame on them all.

Returning to the statements on ED waiting times, a fortnight ago in the Dáil, Members recognised the absolute severity of hospital overcrowding, including emergency department overcrowding, when a detailed comprehensive Sinn Féin motion was passed noting the current state of the health care system, the causes of this chaos and real solutions that the Minister should address.

The shocking statistics around emergency department overcrowding include that there could be between 300 and 350 excess patient deaths each year due to the trolley crisis and the overcrowding. The scandal of patients waiting on trolleys was declared an emergency by the former health Minister, Ms Mary Harney, in 2006, when the trolley count reached 469. Twelve years later, on 2 January 2018, 677 patients were left on trolleys - the highest number ever recorded. Throughout 2017, almost 100,000 patients were left to spend a night or more on a trolley in hospitals throughout the State. I could go on and on.

I have been watching the situation carefully in my area of Dublin South-Central on behalf of the community. In my local hospital, St. James's, in 2017, a total of 47,500 patients attended the emergency department. A total of 2,178 of these were left on trolleys. Yesterday, there were 18 patients waiting on trolleys in that hospital. In reply to a parliamentary question, the HSE outlined that in the event that all possible escalation steps have been exhausted and overcrowding persists, a package of measures, referred to as the full capacity protocol, is to be activated. The beds given are not always the appropriate beds. St. James's Hospital initiated full capacity protocol in February of 2017. That is unacceptable.

Even the most vulnerable children, including those with complex medical needs, are not safe from the ED chaos. A total of 34,735 children attended the emergency department of Our Lady's Children's hospital in 2017. They are not being seen to with the care that they deserve. Nine were on trollies yesterday. We need more beds. There are capacity issues.

There is a curiosity that perhaps the Minister could sort out for me. In St. James's Hospital, it appears there has been a significant decrease in the number of beds over the past year. In January, 2017, the HSE advised me that there were 837 inpatient beds and yet a parliamentary question reply that came in yesterday states that as of September 2017 there were only 686 inpatient beds, an anomaly of 151. I am not sure if that is correct. Is it anything to do with the development of the national children's hospital? If so, it is no wonder we are seeing an increase in waiting times.

I have long stood in this Chamber as a advocate of a community-owned approach to our health and well-being. There is a certain level of attendance at ED which does not need to be there simply because there is no other place to go. One such pertinent example is the presentation of psychiatric patients in the emergency departments. The 2017 review of the National Clinical Programme for the Assessment and Management of Patients Presenting to Emergency Departments following Self-Harm, argued that "...a high number of patients without physical health needs have been presenting to the ED. They would be better assessed by a Community Mental Health Team."

This is the age-old call from me, Mental Health Reform and others for the desperate need for 24/7 crisis intervention and home-based management mental health teams within the community run for and by the community. The lack of this service is damaging our people and placing them in an already full-to-the-brim emergency department which is inappropriate and dangerous on all levels.

The Minister will be aware of recruitment and retention. Unfortunately, what we are spending on nursing budgets is going towards private health care. Our Lady's Children's Hospital in Crumlin spent five times the entire annual agency budget for 2013. We need a great deal of step-down facilities. I suppose the Minister just needs to get on with it.

I want on the record my absolute concern, and worry from a clinical perspective as a nurse by trade, at how dangerous this emergency crisis is. The INMO called it a humanitarian crisis yesterday. Over half of the population who cannot afford private health care are the ones at risk of this health care chaos and we need to address that.

Lastly, Senator Swanick is well able to represent GPs and medics. My emphasis is on the largest sector in the health services. There is no competition here. I refer to the nurses. We really need commitment to funding of the taskforce on nurse staffing to determine, on an evidence-based patient dependency scientific tool, the numbers of nurses required. It is at pilot stage. Can the Minister confirm its rollout, the additional nursing posts required for increased capacity and the ratio of nurses to patients?

I would appreciate if the Minister would ungag himself and answer the question on having parents at the table for the national steering group on the complex needs of seriously ill children.