A press conference is being organised by the Irish Nurses and Midwives Organisation to unveil the results of research carried out by Dr. Keith Hurst, an international expert on comparative medical staffing levels. The results of his research are stark and frightening. They suggest patient safety is being compromised and give the lie to the notion that front-line services are being protected. One finding is that comparative staffing levels are significantly lower than in the United Kingdom. For example, there are six fewer staff in 25-bed surgical wards here and 3.5 fewer staff in medical wards, 13.5 fewer staff in AAUs and 3.25 fewer staff in wards providing elderly care. I do not know if the Tánaiste is aware that last week a report was published by the relevant authority in the United Kingdom which indicated that in 25% of units in the United Kingdom, which are significantly better staffed than ours, nurse staffing ratios were below minimum safety standards, which resulted in hundreds of premature mortalities. The Tánaiste will be aware that the Government proposes to reduce staffing levels in the health service by 3,700 during the next 12 months and by 3,700 the following year. Taking all of this into account, what assurance can he give to the people that the Government is maintaining a safe health service for those forced to use it?
Leaders' Questions
The Minister for Health will examine the results of the INMO study when published. Without the full details of how the work was undertaken and the findings, it is not possible to comment in detail on the study at this point. I am aware that other studies have cited figures which suggest Ireland has a more favourable nurse to patient ratio than in the United Kingdom. The Government has determined, in line with its commitment to reduce the size of the public service, that health sector employment numbers must be reduced substantially in 2013 and 2014. Spending on health services will also have to be tightly controlled. The cumulative impact of staff reductions this year and in previous years presents a significant challenge to the health system in delivering services. The priority is to reform the way health services are delivered to ensure a safe, more productive and cost effective health system. Effective service delivery requires processes to ensure there will be sufficient staff, with the right skills, diversity and flexibility at the right time to provide high quality care.
Skills mix is a central factor in staffing decisions. The Croke Park agreement has been crucial to the ability of the health service to manage in the difficult circumstances of recent years. The flexibility and adaptability shown by staff, including nursing staff, have meant that even with reduced numbers, service levels have largely been maintained, while performance in relation to emergency departments and hospital waiting lists has been markedly improved. In the grace period earlier this year the focus of the Minister for Health and health service management was on ensuring all critical and essential services were maintained. This was successfully achieved through measures that included the reorganisation of resources, more flexible working arrangements and the filling of a limited number of critical posts. The continuing reduction in staffing increases the need for reform, including greater flexibility in work practices and rostering and redeployment. The HSE is committed to fast-tracking innovative and more efficient ways of using reduced resources, including by providing for greater flexibiliy in work practices and rostering, especially of nursing and medical staff, and the changing of the skills mix. Further flexibility and efficiency measures are provided for in an updated health service action plan which has recently been completed.
The Tánaiste appears to dismiss out of hand the results of this research, even before he has studied it. He must be aware that his colleague, the Minister for Health, in justifying his decision to proceed with a HSE inquiry in the case of Ms Savita Halappanavar, has said he owes a duty of care to the women of Ireland. Is the Tánaiste aware that the recent report from the State Claims Agency indicates that there were 5,600 accidents or near accidents in the area of childbirth in hospitals last year? The total number of accidents and near accidents is 86,000 which cost the health service €81 million in claims last year. Is the Government going to take action on this research? Will it, at a minimum, organise risk assessments of all staffing levels, or is its concern for the safety of those using hospital services confined to bringing forward legislation to deal with the outcome of the X case?
That is a scandalous comment.
Having raised one issue and gotten an answer-----
I did not get an answer - that is the problem.
-----Deputy O'Dea now switches tack to two or three other issues. I will now take each of the points he made in sequence. The Government is not dismissing out of hand the study conducted for the INMO. I told the Deputy in my reply that the Minister for Health would examine the results of that study when it is available. Deputy O'Dea will agree that it is prudent, if not courteous to those who produced it, that we at least await its publication and examine, in detail, what it contains. I said to the Deputy, clearly, that the Minister for Health will do that.
In respect of the reductions in staff that have taken place in the health service, I again pay tribute to the staff who work in our health services, including nursing staff, who have been flexible and adaptable and who are providing the best possible level of care to patients.
The issue is that there are not enough of them.
They are burnt out.
They are taking on additional responsibilities and extra work as part of the undertakings to which they committed under the Croke Park agreement.
In respect of the issue that Deputy O'Dea now attempts to raise, it is unworthy of him to try to haul into this question the tragic case of Savita Halappanavar. The Deputy's party leader, only a week ago, acknowledged that this country is one of the safest in the world for childbirth.
I call Deputy McDonald, on behalf of Sinn Féin.
Today we read details of the Government's plan to tax the family home, leaked to the media by the Government. The plan to tax the family home is straight out of Fianna Fáil's four year plan.
It is Sinn Féin's policy in the North.
This Government is continuing to implement Fianna Fáil's austerity plan.
What about Sinn Féin in Northern Ireland?
I am glad that Fianna Fáil has had a Pauline conversion on the road to Damascus.
Sinn Féin would know all about that sort of thing. The consequences would be worse if they had not converted.
That party now opposes its own policy, it seems, in a truly remarkable spectacle of political gymnastics.
The Deputy seems to be very worried about us.
The party might be a bit late in terms of convincing the electorate, however.
The plan to tax the family home is a crazy policy.
It is Sinn Féin policy in the North.
Please, Deputies.
There are two Sinn Féins.
The Deputies are wasting time. Thank you. The Tánaiste will have a chance to reply.
Sinn Féin are the arch partitionists.
The Tánaiste knows that we are dealing with the consequences of a burst property market; that people were ripped off and paid outrageous sums for houses which have subsequently lost 50% or more of their value; that young couples are left raising children in one and two bedroom apartments or houses that are too small, with no prospect of moving on; that there are 160,000 families in mortgage distress, who cannot pay their mortgages and who are struggling on interest-only mortgages; and that thousands have paid out huge sums in stamp duty. Now the Government comes along and slaps a tax on the family home.
It is good enough for the people of Newry.
The Tánaiste ought to be ashamed of himself for doing this.
What about the Ministers and their tax breaks?
Why is the Government continuing to take the soft options? Why does the Government continue to place the burden on low and middle income families, on the coping classes and the working poor? Why is it that the Government is continuing with this plan to tax people's homes which is one of the failed policies of Fianna Fáil?
What is the Deputy doing about it in the North?
The Deputy is being very partitionist.
Deputies, please. There are some Deputies making noise in this Chamber who should know better. The Tánaiste to reply please. Thank you.
Sinn Féin used to believe in equality between North and South, which is a view to which I subscribe.
There are two Sinn Féins.
The Tánaiste does not need any help.
The tax in the North pays for services.
Deputy McDonald will know that a house valued at £150,000 in Antrim is subject to a property tax of £1,100.
Yes, but what do the taxpayers get for that?
Services are actually provided.
Settle down, Deputies, please.
The owner of a house valued at £100,000 in Strabane pays £714 in property tax and a house-----
When the shinners get in that will all change.
Deputies, please, there is a time limit on this question.
A house valued at just £75,000 in Coleraine is liable to a property tax of £506. Does the hypocrisy-----
Who would want to live in Northern Ireland?
At least they know what they are getting for their money.
Please allow the Tánaiste.
Does the hypocrisy of Sinn Féin know any bounds at all? The position is that the Government made it clear that we will introduce a local property tax which will replace the household charge. That is a budgetary matter which is under consideration by the Government and the Minister for Finance will announce the details of it on budget day.
I do not think that the Tánaiste's attempts at diversion qualify as an answer.
Deputy McDonald really walked into it this time.
Sorry, Deputies, we do not need your help.
If he had done his research, the Tánaiste would know that the rates system in the North is a world away from the tax that his Government proposes to place on the family home.
It is only a few miles up the road.
It is a world away from it.
Deputies are on their final warning. The next person who causes trouble, from either side, is out. Do Deputies understand me? I am not putting up with abuse about my chairing of the House while Deputies get away, scot free, for roaring and shouting. Deputy McDonald to proceed, without interruption.
How does the Tánaiste imagine families will find an additional €400 or €500? Where are the exemptions? The media reports refer to deferrals of payment of the tax on the family home but a deferral is not a waiver. I ask the Tánaiste, at the very minimum, to reassure those who are out of work, who live on a pension and those who literally count the cents - not the euros, but the cents - month on month, as they try to meet their bills, that the Government will grant waivers. Even if the Government is minded to proceed with this crazy policy, I ask that the Tánaiste have the decency to take account of the reality of people's lives and to grant extensive waivers. I ask him to spell that out now.
It would be advisable for Sinn Féin to at least await the announcement of the budget before it starts charging in, attacking what it thinks are elements of it.
The information came from a Government source.
The party should at least await the announcement by the Minister for Finance on budget day. The budget will be a difficult one, although I note that Sinn Féin in its pre-budget submission acknowledges, on this occasion at least, that an adjustment of €3.5 billion will have to be made this year. Deputy McDonald can rest assured that the budgetary measures introduced by the Minister for Finance will be fair and balanced.
I call Deputy Boyd Barrett.
A number of weeks ago Social Justice Ireland revealed that one in ten children goes to school without proper clothing or breakfast. The CSO revealed recently that 10% of the population is living in food poverty. Today we read, in a report from Trinity College and the ESRI, that two thirds of families of thousands of teenagers surveyed for the Growing Up In Ireland study are experiencing significant hardship and that the number of families in that situation has doubled in four years. Another survey reveals that nine out of ten people believe that after the forthcoming budget they will have less money to pay for basic food items.
It is incredible that poverty and hunger are stalking the land in the 21st century. Against this background the Government plans to impose a tax of between €400 and €500 per year on the homes of already struggling families. Is there any red line the Labour Party will not cross? Is it willing to drive hundreds of thousands of families into poverty and hunger? Can the Tánaiste give us an assurance that those who are already struggling to put food on the table, clothe their children and pay their bills will be given protection and perhaps even relief in the forthcoming budget?
Once again Deputy Boyd Barrett manages to twist things. The figures he cited refer not to people who are in poverty but to those who are at risk of poverty. The reality is that Ireland has one of the lowest levels of poverty risk in the OECD. That said, however, poverty and risk of poverty are real concerns for this Government. That is why we have to restore our public finances. We are borrowing €3 out of every €10 that we spend on social protection, education, health and delivery of services. If we cannot continue to do that we will be condemning the children of the future to poverty. This Government is not going to do that. Our priority is to restore our public finances so that we can pay for the social protection programmes required to keep people out of poverty and in a decent living. That is why we have prioritised getting people into employment, sustaining employment and working towards a sound economy. The best way of getting out and staying out of poverty is to have a job and a decent income. That is the priority of this Government.
Although we would all wish it were otherwise, we are in a financial crisis. We can complain forever about why we got into that financial crisis or who was responsible for putting us into it, but the responsibility of the Government, which we are not going to shirk, is to get out of the economic crisis and ensure the country has the resources to provide for our people and keep them out of poverty.
Deputies
Hear, hear.
I will take that as a "No". The Tánaiste cannot give an assurance to hundreds of thousands of families who are living in poverty. Approximately 700,000 children live in poverty and hundreds of thousands more are hovering just above the poverty line. He cannot assure them they will be protected or get relief from the dire circumstances they face.
The Tánaiste says there is no alternative because we must restore the public finances. A couple of weeks ago I asked a question on corporation tax which revealed that corporations that made profits in this State of €61 billion last year only paid an effective tax rate of 6.5%. If the Government brought the rate up to 12.5% it would raise between €3 billion and €4 billion and do away with the need for property taxes or further cuts in health services and education. Will the Government make corporations with multi-billion euro profits take the hit rather than families who are struggling with poverty and, in some cases, hunger?
I can give an assurance to people in this country that the approach we are taking, which is a rational approach to dealing with the financial and economic crisis-----
Obviously he was being irrational in Opposition.
-----will restore our economy, get people back to work and ensure the country has the money to provide for social protection, social services, education, health services and all the other services we need to ensure people do not slip into poverty and are supported in getting out of poverty. That cannot be done by simply shouting at the problem.
Increase the effective corporation tax rate.
Do not be daft. The rate of corporation tax in this country is, by any standard, a strong and effective rate.
These companies paid €4 billion in tax out of profits of €61 billion.
Deputy Boyd Barrett should get a grip. Stop shouting slogans at everything.
They are from your manual.
We need to continue to attract companies that will invest and create jobs here. Last year was the best in the past decade for attracting inward investment to generate direct and spin-off employment in the domestic economy. Deputy Boyd Barrett simply does not want them. He wants to chant slogans at them. He wants to send them away.
I simply want them to pay tax.
They are paying tax.
We are over time.
These are the people and companies that we want to attract to this country in order to create jobs. That is how we will get out of the economic crisis, not by running around like a blue-behind fly waving slogans.
With placards.
Signing pledges.