Paul Gavan (Sinn Fein) | Oireachtas source

It is nice to see the Minister here and I thank him for coming to the House. I think we can agree this is a difficult topic. I have real concerns over where we stand with Sláintecare. When three of the most senior people on the advisory implementation council resign and say they are resigning because they do not believe the Government is committed to implementing Sláintecare, that is a major problem. Deputy Shortall put it best when she said the Minister's dropping of the advisory implementation council amounted to a hostile takeover, effectively shooting the messenger because people have pointed out that the commitment to Sláintecare - a public system of care and a national health service, if you like - has not been seen in practice. Certainly, in his speech this evening, the Minister has not addressed the issue as to what mistakes were made that led to these people giving up hope and resigning their positions. I ask him to address that and his response.

I want to put this in context. I accept what Senator O'Loughlin said earlier that these things take time. Health services do not mend themselves overnight. Sláintecare is five years old. Fianna Fáil and Fine Gael have been putting together budgets for some time. I believe this is their sixth one in a row. We are now five years into the implementation of Sláintecare and surely to God we should have made more progress than we have.

I am particularly struck by the concerns expressed by one of those who resigned over the Minister's commitment to implementing regional structures. Laura Magahy described those structures as a critical enabler. In fairness to the Minister, he addressed it in his speech. However, I am concerned about what he said about implementing regional structures. He said that substantial work is also ongoing on implementing regional health areas. He then went on to describe a number of actions that really just look like further research options. The term he used was implementing regional health areas.Here is an easy one for the Minister to come back on. When are these areas going to be implemented? Will he simply tell us when? That would be progress. A simple answer would suffice.

I have great concerns about those on the front line. I speak as someone who used to represent health workers in University Hospital Limerick, UHL. I met with union officials only the week before last and they told me that morale was absolutely on the floor. Why would it not be? The Minister will be aware that, as hospital management conceded to me, UHL is 200 beds short. There were 90 people on trolleys last Wednesday. We are in the tenth year of Fine Gael government and, each year, things have gotten worse rather than better in the hospital. I include in that the six or so years in which we have had budgets from Fianna Fáil and Fine Gael together. That is why the INMO said: "Many of my colleagues across the country are feeling utterly unsupported in their workplace, with no sense that much-needed health service reforms are supported by Government." The Minister can criticise Sinn Féin if he likes, which the Government parties like to do, but will he address the real concerns expressed by front-line workers? He might also consider the SIPTU representative in Tralee who told us there is now one nurse for every 15 patients there. There is a massive problem.

The problem is that there is a revolving door as regards health staff. People cannot cope with the appalling circumstances they are being asked to work in. Fine Gael has had ten years to address this but has failed utterly while Fianna Fáil is on its sixth budget but it has failed utterly as well. There is an ideological issue at the heart of this. Let us be frank: for decades, Fianna Fáil and Fine Gael were committed not to a public healthcare system, but to a two-tier system. That is what they defended. We never had the radical change after the Second World War that social democracy could bring because we never had a social democratic government. I do not see commitment from the Government in practice. The workers on the front line in UHL do not see or feel that commitment either. They do not have any confidence in this Government.

We spoke to staff in the National Ambulance Service, who came up with several good suggestions to divert people so they would not all have to end up in the emergency department. Its representatives told us of their frustrations as regards getting these policies implemented and of their concerns over their own staffing needs. I acknowledge that a review is under way in that regard.

To conclude, the Minister is not delivering. Those are not my words but those of the front-line workers I have met and quoted here this evening. The next time he comes before the House, there will need to have been some fundamental change. Fundamentally, the Government is not working towards a national public health service. That is evident for everyone to see.