Tuesday, 8 October 2019
Budget 2020: Statements
An additional €1 billion is being allocated to the health budget. Some €335 million of that commitment is for the estimated overspend in the system that happens year in, year out. It is never recognised but the money is always given and it is taken as read that there will be an overspend. That is because our population has grown.People are living longer. There are more successful treatments and increased demand. Our environment is less pure. We do not seem to be able to get our heads around the fact that more people means much greater demand, but we keep curtailing the increase each year to 6% or thereabouts. Out of the €1 billion, €335 million is gone. The medical agency staff who are holding our fragile system together cost millions every year and we are not getting value for money in respect of them because they are not committed to particular areas in order to grow their expertise and professionalism in those areas. They move about because we still have a moratorium on hiring medics. A few hundred million of that pot of money is left afterwards. The national children's hospital will put its hand out and ask for more. We all know that is coming down the line. IT has not been costed in BAM's budget. It is one of the major investments required for this high-tech hospital.
Apart from that, I see constant problems with capacity, recruitment and retention. Where are the beds that have been closed and the wards that lie empty while other wards are at 150% capacity and stressed? I have not heard about anything being invested in trying to get staff to stay or to return, or about making the health service a better place for them, for patients and for us all.
There is an additional €1 million for home supports but this will not even clear the home support waiting lists, which currently stand at 7,300. The Government could have used this budget, had it been a fair one, to completely eradicate waiting lists for home support and remove the burden of care from those who are caring for loved ones. However, that has not happened.
The National Treatment Purchase Fund was introduced by Fianna Fáil and it agreed to it for this budget, as it agreed to everything in this budget before it was delivered by the Minister. Perhaps Fianna Fáil Senators are not here to moan and complain because it was all agreed beforehand. There are nearly 700,000 people on waiting lists. The response has been the allocation of €25 million for the National Treatment Purchase Fund. It is a continuation of inefficient use of funds because it does not realistically reduce waiting lists in the long term. It just massages the numbers and every health economist will tell the Minister of State that. Dr. Sarah Burke, a respected, independent health economist at the centre for health policy in Trinity College Dublin, nailed it when she stated that over a decade of pouring hundreds of millions into the National Treatment Purchase Fund has proved that it does not address the underlying causes and long waits for public patients. It is a very poor return on such a large investment.
I talked about the wards that are closed. I want to address mental health. Do I have much time left to speak?