Shane Cassells (Fianna Fail) | Oireachtas source

I thank the Minister for being present. Last Saturday, when people took to the streets across the country there was a palpable sense of exhaustion and frustration. That is even worse than anger because people genuinely feel that nobody is listening. When the Minister faces that mammoth task of reforming and making fit for purpose the massive entity that is our health system, he relies on the advice of many different strands of medical professionals so that he can make the best calls in cancer care, maternity care, community care and in so many different areas where improvements are happening and differences are being made. He has specialists in those fields who are telling him what they think is best. While none of us here are medical experts, we have expertise in the fields of how societies are structured and what components are needed to make that function properly. For those of us who have come through the local authority system, in particular and who have spent years working on county development plans and who have spent endless hours and meetings working on minutiae of where education, childcare, sport, industry and health facilities need to go, we know what it takes to put all those aspects together so that people can access what they need and what makes a town work. This is all about access.

As the Minister said in his opening speech, there is an unacceptable number of patients on trolleys. We have a population that is increasing, in particular on the commuter belt on the east coast. Ordinary people who are living in these centres of populations that planners who are employed by this State have created cannot for the life of them understand why the emergency healthcare that their population centres demand is not available for them. Neither could I, until last May when I sat in the boardroom in the Department of Health with all of the top people from the HSE and the Royal College of Surgeons in Ireland. I asked them to their faces if any of them in their decision-making process had familiarised themselves with the development plans of the counties where they were making decisions that impacted the people that live there. The blank faces of these eminent medical professionals told me all I needed to know. They had not.

The Minister speaks of better access for patients, and it is not happening for a reason. When you build a house, you have a plan. When you build a town, you have a plan. The people who are charged with important arms of our State, such as those in the Department of Education, law enforcement and industry, read these plans accordingly and they plan for that but our health managers do not seem to think that these development plans are important because they operate in their medical silo. That might be okay for them, but it is not okay for our citizens, because the failure to plan is what is resulting in these deficiencies in our society. It is exactly why Limerick is a mess and why this impacts towns such as Ennis. This is why I stand in defence of my hospital in Navan. It is madness to take two of the fastest-growing towns in the entire country with a population of 40,000 men, women and children each and then combine them into one, overcrowded hospital and think that is a plan. It is dangerous, as I demonstrated and as I had warned prior to Christmas when 11 ambulances were backed up in the car park in Drogheda. Nobody thinks that is acceptable - not the planners I have spoken to across the region, not the politicians, not the patients and not the ordinary men and women on the streets with whom I stood outside my hospital in Navan last Saturday. They do not understand why they are expected to be triaged in a car park in Drogheda. It is not acceptable. We cannot stand over it. It would not be tolerated anywhere else.

The debate on access needs to be turned on its head. Instead of the HSE trying to close accident and emergency departments, we need plans for investment, such as the already authorised north-east regional hospital that was supposed to be based in Navan. I implore the Minister to engage and turn this debate on its head. He has led reform across so many areas. Let him now engage with us on reforming this area as well.