I move:
That Dáil Éireann notes, that during the four wasted years of the term of office of this Government,
(a) many public health services have actually deteriorated causing pain and suffering to those in need of treatment, care and support;
(b) despite the urgency of the crisis now facing the health service, at the much hyped special Cabinet meeting held at Ballymascanlon on 14 May, no decisions were made nor any initiatives agreed to improve the situation;
(c) the clear divisions between the Minister for Health and Children and the Minister for Finance which are a further obstacle to health care reform;
and deplores, in particular:
–the failure of the Minister for Health and Children to create a customer-focused health care service as promised in An Action Programme for the Millennium, or to produce any comprehensive programme of health reform;
–the failure of the Minister for Health and Children to deliver on the commitment given in An Action Programme for the Millennium to tackle the crisis in hospital waiting lists, as almost 28,000 public patients are waiting for treatment and waiting times in certain specialties have increased;
–the failure of the Minister for Health and Children to substantially improve mental health and autistic services as promised in An Action Programme for the Millennium, especially in view of the restrictive nature of the Mental Health Bill and the deplorable delay in progressing it through the Oireachtas;
–the failure of the Minister for Health and Children to increase income levels for eligibility for medical cards for large families, as promised in An Action Programme for the Millennium, as a result of which many people in need are deprived of access to the level of health care they require;
–the failure of the Minister for Health and Children to tackle the grave inequity caused by the two tier nature of our hospital system;
–the failure of the Minister for Health and Children to provide the additional beds in acute and non-acute hospitals needed to provide for our growing population;
–the failure of the Minister for Health and Children to introduce repeatedly promised legislation to further control tobacco advertising, despite the continuing toll that smoking takes on health and the additional financial burden placed on the health service;
–the failure of the Minister for Health and Children to honour commitments made in February last to ensure speedy repayment of moneys improperly demanded from adult children of those in nursing homes;
–the failure of the Minister for Health and Children to end the practice of keeping patients with intellectual disabilities in psychiatric hospitals;
–the failure of the Minister for Health and Children to ensure adequate community care services to support families caring for dependants in the home;
–the failure of the Minister for Health and Children to deal with the serious shortage of nursing staff or to address the concern of nurses in regard to working conditions;
–the failure of the Minister for Health and Children to fill all the 29 consultant AE and anaesthetist posts announced last October under the winter beds initiative;
–the failure of the Minister for Health and Children to fully progress the commitments made on working times and conditions for non-consultant junior hospital doctors;
–the failure of the Minister for Health and Children to deliver a full national breast cancer screening service and cervical cancer screening service;
–the failure of the Minister for Health and Children to deal with the serious crisis in the orthodontic service, especially in the Eastern Regional Health Authority area where more than 12,000 people are awaiting treatment or assessment;
–the failure of the Minister for Health and Children to adequately fund the child welfare and protection services resulting in growing waiting lists for social work services and inadequate residential care services for many children at risk;
and instructs the Minister for Health and Children to report back to the Dáil not later than the last day prior to the summer recess, on what progress he has made on all of these issues.
I wish to share time with Deputies Stagg, Penrose, Rabbitte and Upton.
The Labour Party is tabling this motion because it recognises health as the most urgent political and social issue facing the public. It is obvious that the Government is neither aware of the depth of the crisis, nor is it capable of producing a coherent response to tackle it. The much-hyped Cabinet meeting at Ballymascanlon was supposed to deliver on health care and silence the critics of the Government's failure to address the crisis, or so the Minister for Health and Children, Deputy Martin, wanted us to believe. Instead it resulted in a ministerial mauling, a Cabinet in confusion and a victory for the hard right. The slapping down of the Minister for Health and Children by the Minister for Finance, Deputy McCreevy, left no doubt as to the true nature of the Government. In the face of an ideology that rewards the rich and denies the poor in successive budgets and discriminates in health care on an ongoing basis, the Minister for Health and Children is like a rabbit caught in the headlights of the Mercedes of the Minister for Finance. The Minister for Health and Children wants to spend more money on health while the Minister for Finance wants to stop spending more money on health. Both have spelt out their positions and both are wrong.
We need more money for additional beds and staffing and value for money. However, unless the health service is based on proper funding allied with a new dispensation of universal care and a new relationship between patient and care provider, the opportunity to deliver a world class service to all our citizens will be lost. We have the economic capacity to provide such a health service. The Labour Party has set out the framework for a 21st century health service based on a universal insurance scheme that would encompass everyone, regardless of means, and ensure those of us who can afford to contribute towards it would do so. Such a system would provide the safeguard of a free general practitioner care service while maintaining the current drug schemes. It would integrate primary care with secondary care in order that only those who need to be in hospital would go to hospital and it would encourage effective health promotion. It would abolish the two tier system in our hospital sector whereby hospital consultants are paid differently for their public patients and their private patients leading to gross inequities and waiting lists. Under our proposals the patient would be central to the service because the money would follow the patient.
We have set out the framework which would deliver care on the basis of need, guarantee excellence of care and encourage value for money. After four years in office the Government has still to declare how it intends to tackle the issues. They have been four wasted years. Why should sick Irish people expect anything less than the best? Other European peoples expect quality care when they need it and that is what they get. The French health system is the best in the world; yet, the French economy is not growing as fast as ours, nor are they wealthier than us anymore. The most disturbing aspect of the meeting at Ballymascanlon is that it is clear the Government has no intention of reforming the health service, it never intended to and is not going to. It has run out of time and what is needed is not just a new start in health care but a new Government to deliver on it. The record speaks for itself. During the four wasted years of the Fianna Fáil and Progressive Democrats term of office there has been unprecedented prosperity and a real opportunity to create a quality health service for all our people. Instead of taking that opportunity the Government has presided over a deepening crisis.
The opportunity was squandered first by a Minister who did not know or care about health reform. Never was a Minister more glad to be rid of a Department than Deputy Cowen. When he left his legacy was two years of industrial relations chaos, ward closures, shattered morale among hospital professionals and lengthening queues. Now Deputy Micheál Martin is in the job, though not in the driving seat. Thatcherism has put him in his place and now, as if things were not bad enough, we have the Minister for Finance imposing his ideas on health care. The McCreevy solution is not to increase bed numbers but simply to remove private beds out of public hospitals. Like many of his views, it is simplistic and superficially attractive. It is also wrong. It ignores the fact that the vast number of admissions nowadays are through accident and emergency departments while 50% of people take out health insurance. The increased cost of his approach would force more people out of private health insurance and on to the public waiting lists which, in turn, would put additional pressure on public beds. The cycle would become more vicious.
Under the proposals from the Minister for Finance, our health service would become worse and more unfairly divided between those who can afford to buy quality care and those who are denied it. The Minister is proposing the US model of health care and the Taoiseach appears to be happy to row in behind his right-wing ideologue in the Department of Finance. He wants to know what crisis we are talking about. The Taoiseach is adamant there is no crisis in the health service. At Ballymascanlon there was subliminal jostling for position in the next leadership contest within Fianna Fáil, but the sick and dying are the losers. They are the victims of a Government which has grown complacent and is protected from the harsh realities affecting the sick. The desperate state of our health service impacts directly on the most vulnerable – the elderly, the poor, the ailing and those who cannot afford to buy any American style health care the Minister for Finance might like to offer.
It is clear that, despite his good intentions, the Minister for Health and Children is powerless to make the necessary changes. He has not succeeded in reaching his own modest targets. Last October he announced with great fanfare his winter beds initiative and the appointment of 29 new consultant posts. Eight months later, as we approach midsummer, 450 hospital beds are still inappropriately occupied and all the consultant posts have not been filled. Hospital wards are still closed and nursing staff are in short supply. Almost 30,000 people are on waiting lists for procedures and thousands more are waiting to see a specialist. The hospital building programme is bogged down. The sick and elderly in our major hospitals are forced to suffer the indignity of lying on trolleys for hours and days while they wait for a bed.
The four wasted years have left a terrible legacy of pain and suffering in their wake. I am talking about suffering such as that experienced by a man who contracted diabetes in middle age and needs an operation in one eye. His consultant says it will be at least six months before he gets it. His general practitioner has told him that if this operation is delayed, his other eye will become affected and he could end up being blind. If he was a private patient, he would not have to wait. What type of country are we living in where the coffers are overflowing, yet a man may lose his sight because he cannot access the treatment he needs and he cannot afford to buy it? I am talking about the type of pain experienced by the young paraplegic who cannot start his rehabilitation because he is stuck on a hospital waiting list for an operation on his legs. I am talking about the anguish of a mother who is afraid to bring her children to her family doctor because she cannot afford to pay him, although she knows they need medical care and attention. I am talking about the 90 year old man who spent days on a trolley in an accident and emergency department because there was no bed for him. Is this what the Government means when it says it is paying special attention to the needs of the elderly?
What about the people who provide for those needs? I am talking about a typical nurse in St. James's Hospital who works three 12 hour shifts a week and a further two 12 hour shifts to pay her £800 a month mortgage. A 60 hour working week for a nurse in an understaffed and over stretched hospital may be value for money in the eyes of the Minister for Finance, but it is not right and it is not sustainable. Our health service is staffed by people of the greatest dedication and professionalism. Is it any wonder they are worn out and worn down by their frustration at a Government which is incapable of addressing the needs of their patients? I have not outlined isolated instances because this is the experience of thousands of people who are forced to endure the deficiencies of an under funded and an iniquitous health service.
We are tabling this motion tonight to highlight how common these experiences are and to affirm that the Labour Party is keeping the needs of patients on the political agenda in every way we can. We are reminding the public of the commitments the Government made when it took office and of the promises reneged on by the Taoiseach, the Minister for Finance, the Minister for Health and Children and all the others. They promised in their Government programme to deliver a customer focused health care service, to tackle the crisis in the hospital waiting lists and to increase income levels for eligibility for medical cards for large families. These promises are on the public record. However, after four wasted years not one of those promises has been kept. Failure is piled upon failure at the Minister's door. He has failed to tackle the hospital waiting lists, to deal with our two-tier system, to provide more beds in acute and non-acute hospitals, to develop community care, to support carers in the home and to cherish our children. The only difficulty we had in drawing up the list of failures of this Government was to decide where to draw the line.
The argument in favour of a health service based on quality and equality is not new. When Dr. Noel Browne was Minister for Health, he attempted to tackle inequality in health care for mothers and children. He made the point at the time that in any two-tier system the better off will get the better service, while the worse off will get the worst service. He fought against means testing eligibility because it institutionalises inequality. He said that in medicine he did not see rich and poor people, but sick people. Dr. Noel Browne fought for the universality of health care, but the forces of reaction defeated him. The Labour Party is fighting today for the universality of health care. The forces of reaction are still with us in a new guise and in this Cabinet, but we do not intend to let them win again.
We are seeking what other Europeans accept as their right – a good, fair, properly resourced and insurance based health system. It is an ambition shared by many people both inside and outside this House. Only 24% of Irish people are satisfied with our health service. That figure is 78% in Finland and 71% in Austria. Satisfaction is also high in France, which is not surprising since it does not have hospital waiting lists. French people live a good deal longer than Irish people. It is possible to provide a quality health system not just to meet the current needs but for an ageing population. France and other countries have done it. There will always be stresses and strains and further demands, but we do not yet have the major demographic challenges facing these European countries. However, we have a Government incapable of meeting the challenges facing us.
It is worth comparing the Government's failure on health with the extraordinary planning, preparation and funding commitments to the establishment of Stadium Ireland. The Government could have chosen to set up a task force to create a world class health service. We could have had the equivalent of a Paddy Teahon or a Laura Megahy in place to take on the work of dealing with the management problems, the anomalies, the staffing shortages, the lack of patient responsiveness and the modernisation project that is demanded if we are to reach the objective of a 21st century health service. However, we do not have that commitment from the Government. We have two Ministers bickering over money, while the Taoiseach, as usual, keeps his head down and out of trouble in a Government which is bereft of direction.
We have heard and I have no doubt we will hear a great deal tonight about the proposed health strategy. Drawing up a strategy when a Government is coming to the end of its term of office begs the question about what this Government is about. At a time when the Government has to defend such an appalling record of the failures listed in the motion, the exercise on which it is embarked is more about trying to rescue Fianna Fáil from the anger of the electorate than it is about reforming and transforming the health service.