I congratulate the new Minister and Minister of State on their appointments to the Department of Health and Children. I wish them well in their new duties. Members on this side of the House, particularly the Fine Gael Party, will put them under considerable pressure. I thank the Labour Party and Deputy McManus for tabling this motion and giving us an opportunity in their Private Members' time to discuss issues of great importance relating to the health service.
It is a national scandal that at a time of unprecedented economic prosperity there is a sickness at the heart of our public health service. The Government promised to reduce public hospital waiting lists. However, approximately 38,000 people are awaiting essential in-patient hospital surgery and treatment, an increase of 30% since the Government took office two and a half years ago. The Government has failed to implement any targeted reforms of, or improvement in, our health service within specified time scales during its period in office. Its approach has been marked by fire brigade responses to various crises and piecemeal initiatives. On occasion, parish pump politics have taken precedence over any coherent strategic plans. The scandalous conduct of Deputy Cowen in his final days as Minister for Health and Children sadly illustrates this.
The National Disease Surveillance Centre was established in Sir Patrick Dun's Hospital in November 1998. The NDSC is being developed as a centre of excellence for the surveillance, prevention and control of infectious diseases. In the 12 month period following its establishment, specialist trained staff to enable it fulfil its functions were head hunted and recruited. As part of the staffing process, in recent weeks the Department of Health and Children approved the recruitment of a microbiologist jointly by the NDSC and James Connolly Memorial Hospital.
The NDSC was set up on an interim basis, pending the enactment of legislation to give it an independent statutory remit. It was proposed that its staff complement ultimately expand to 20 and that it have a permanent centre sited in Blanchardstown. Its work requires it to maintain close and frequent liaison with other national organisations such as the Royal College of Physicians, the Irish College of General Practitioners, the National Virus Reference Laboratory and with academic libraries and university departments. The NDSC has been requested by the Department of Health and Children to develop guidelines on issues such as anti-microbial resistance and viral haemorrhage disease and has been asked to review infectious disease legislation. The Scientific Advisory Committee, through its subcommittees, has more than 50 professionals who have given their time freely to develop these guidelines. Membership of the scientific advisory sub-committees by the professionals who voluntarily give of their time is dependent on these committees meeting in Dublin. All those head hunted and employed by the NDSC reside in Dublin and were recruited on the basis that it would be based in Dublin.
One day prior to the appointment of Deputy Cowen as Minister for Foreign Affairs, the chairman of the board of the National Disease Surveillance Centre received a fax from the Department of Health and Children informing him that a decision had been made by the then Minister for Health and Children, Deputy Cowen, to transfer the centre to Tullamore Hospital. No public announcement was made of the Minister's decision and no explanation has been offered.
It is clear that while the Government may lamely attempt to justify this action on the basis of its commitment to decentralisation, in the context of the agency concerned and the location to which it is being sent this is nothing more than parish pump politics at its worst. If the Government persists with implementing this proposal, it is likely that most, if not all, of the staff recruited to the NDSC over the past 12 months will seek other positions. A newly established national institution, with a remit of great importance in the context of the future workings of our health service, has been treated by the Government as little more than a parting political gift to his local town by a departing Minister, given to commemorate his time in the Department of Health and Children.
As a consequence of the Government's failure to put in place and properly promote a comprehensive 'flu vaccination programme this winter and last, patients with 'flu and respiratory viruses who required hospital admission have put our major acute hospitals under intolerable pressures. This year, like last year, patients who already had to wait too long for essential surgery had their already delayed surgery further postponed.
In the midst of a deep economic recession in 1987, 20% of the beds in our acute hospitals were taken out of service. Despite the extraordinary up-turn in our economy, they have still not been restored. Even more astonishingly, during the lifetime of the present Government the overall number of acute hospital beds has been further reduced. At the beginning of 1997 there were 12,356 acute beds, by February 1999 these had been reduced to 12,292. In 1997 there were 9,030 public acute hospital beds; in December 1999, despite increased demands on our hospitals and the dramatic escalation in the waiting list, the number was reduced to 8,995.
With our population increasing and people living longer, the proportion of elderly patients will continue to increase. Yet, to date, the Government has failed to put in place the essential additional nursing home and step-down facilities required to provide care for elderly patients who need to recuperate before going home but who do not require acute hospital facilities. Instead, the Minister for Health and Children has financially penalised various hospitals throughout the country for retaining elderly patients in need of care who live on their own and who lack the strength and well-being to return home.
The failure of the Government to provide sufficient resources to our health services is directly responsible for escalating hospital waiting lists, insufficient acute hospital beds, closed beds, wards and theatres and a crisis management ethos permeating our public health service. It is also the reason for the inordinate delays that occur in the implementation of long awaited sectoral health strategies, such as the cancer strategy.
As at 30 September last, there were 1,180 nursing posts vacant in our health service. Some 95% of the vacancies occurred in the Eastern Health Board area and voluntary hospitals, and the majority of these posts still remain vacant. As a consequence of these vacancies, hospitals with responsibility for national specialities, such as cardiac surgery, have been unable to meet targets prescribed in their service plan, operating theatres are either closed or under utilised and the waiting times for patients requiring essential surgery have substantially increased. As a consequence of these vacancies, nursing staff have been forced to work under intolerable pressures. The Government has failed abysmally to anticipate our nursing needs and to put in place policies to encourage and facilitate nurses with specialist qualifications obtaining or remaining in crucial nursing jobs within the Eastern Health Board area.
Instead of putting patients first, the Minister for Health and Children has targeted patients and implemented policies to penalise the sick. Increases by the Government this month in the cost of private beds in public hospitals have guaranteed that private health insurance payments will increase by 9% again this year. No recognition is given by Government to the fact that the 42% of the population who pay private health insurance are also, through their taxes, entitled to free hospital care. If they relied solely on our public hospital system, our waiting lists would double and the health service would implode under the strain.
Our health services require radical reform. Whether the necessary reform can be brought about by the introduction of a universal health insurance system is questionable. What is needed is less, not more, bureaucracy. In the area of health insurance, what is required is more, not less, competition. The core problem is not the public-private mix. It is the absence of public health service planning, a gross inability to use resources efficiently, a failure to put in place modern management techniques and information gathering systems and a lack of dynamism.
Greater resources need to be allocated to primary care, health promotion and health prevention. The acute beds taken out of our public hospitals over a decade ago must be restored to the system. New imaginative initiatives are needed to ensure we have the number of specialist doctors and nurses required to cut our waiting lists in half. We must also reduce waiting times to ensure no person, either adult or child, need wait in excess of six months for essential in-patient hospital surgery or treatment, or wait in excess of three months for an assessment by a consultant after a GP referral. A new patients' charter which imposes a statutory duty on health boards to provide essential in-patient treatment within specified timeframes should be put in place. There is also a need to target resources for the provision of patient care and to put in place a more cost effective health administrative structure. Capital and current resources must also, on a planned basis, provide the essential nursing home and—