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Dáil Éireann debate -
Thursday, 18 Apr 2013

Vol. 800 No. 1

Leaders' Questions

The Minister for Health, Deputy Reilly, is assuring everyone that the health service is getting better and waiting lists are getting shorter. He assures us that patients who are waiting the longest for treatment are in fact being treated. Unfortunately, the facts and figures confirm that since taking office, the number of adults waiting for surgery in the country's hospitals has actually increased by a dramatic 40%. The latest figures show that 13,435 adults were waiting longer than six months at the end of March. This is a damning indictment of the stewardship of the Minister, Deputy Reilly. There now are more patients waiting for treatment for longer than six months, eight months and nine months. When contacted about this situation, the Department of Health has confirmed and states it is due to severe pressures on emergency departments although this is another area the Minister, Deputy Reilly, stated recently was under control and getting better.

On the ground, however, nothing could be further from the truth. For example, in the past three weeks alone, all elective surgery except for paediatrics has been postponed in Cork University Hospital. In that hospital, a daily e-mail is being sent to the wards telling them to cancel all elective surgery. This includes cardiac, orthopaedic and neurosurgery and, most shockingly, it includes cases for the treatment of cancers. Consultants inform me that it is practically impossible to plan any elective surgery as the accident and emergency department is so busy.

That hospital is finding it extremely hard to cope and while three wards are closed in that hospital alone, 84 wards are closed across the country's public hospitals. In addition, 408 patients were on trolleys yesterday in accident and emergency units across the health system. Yet again, this is an area the Minister for Health, Deputy Reilly, states is under control.

Is the Minister, Deputy Reilly, in denial or is he living in some fantasy land? Does the Tánaiste accept that severe issues now face the health service and that the centre within the health service can no longer hold? At present, 2,277 public beds in the health service are closed and elective surgery, even in cancer cases, is being postponed as a result.

Thank you, Deputy.

These are not my figures but come from the Irish Nurses and Midwives Organisation, which, on entering office, the Minister, Deputy Reilly, indicated he would accept as being the official figures in respect of trolley count, enclosures and so on.

Thank you, Deputy.

Does the Tánaiste acknowledge the health service is now under extraordinary strain and requires dramatic intervention by the Government to arrest the crumbling across the board of all aspects of the service it attempts to provide for the people?

First, from the very outset the priority of the Government has been to unblock access and to improve the flow of patients because patients are its number one priority. As set out in the programme for Government, the Minister for Health established a special delivery unit immediately on foot of the Government entering office. The aim of the special delivery unit is to unblock access to acute services by improving the flow of patients through the system. The Government's commitment to improving access is clear and part of it pertains to the reform of hospital services.

However, it is important to be clear about the facts in this regard. A figure of 13,435 adults waiting for planned procedures has been quoted in the media and Deputy Martin repeated it this morning. I am informed that this figure is incorrect. The actual figure I have to hand is 10,002 at the end of March and that has been published on the National Treatment Purchase Fund's website, www.ntpf.ie. This constitutes an increase of 4% from the figure of March 2011 and not 40% as the Deputy has alleged.

However, when considering these numbers, one must take into account both the numbers of people who are on the list and the period of time they have been waiting. In March 2013, the median waiting time was 2.4 months, which was a decrease from the equivalent figure of three months in March 2011. Moreover, when the special delivery unit was set up in July 2011, a total of 6,277 patients were waiting for more than nine months for inpatient or day case treatment, and this was a legacy left by Deputy Martin's Government. However, by December 2012, just 109 patients were waiting for longer than nine months, and this is an achievement that ought to be acknowledged.

However, the Government is not complacent. The progress does not mean the problem has been solved. The Deputy asked me whether the health service is under strain and the health service always is under strain. The Government is addressing that strain, reducing the length of time that people are waiting and dealing with the situation on the ground. There has been an increase in the number of people presenting at emergency departments over the past couple of months.

As Deputy Martin knows, that is a seasonal phenomenon. The Minister for Health and the HSE are working to bring the number down.

The first thing the Minister did when he came into office was change the targets. The internationally recognised targets for waiting lists were three months and six months. He unilaterally said it is 12 months. He had to massage the figures and perpetrate a con trick. That is what he did. The SDU has refined his machinations to nine months and over. The figures for three months and over and six months and over have rocketed over the past two years. The trolley count has also rocketed in the past few weeks. There is a fundamental problem which is more than just a case of the services being stretched. The Tánaiste has not commented on the fact that there is an e-mail going around a major acute tertiary hospital telling consultants and the wards not to do elective surgery. Elective cardiac and cancer surgery and neurosurgery is lifesaving surgery. It is unacceptable that this should be happening.

A further cut of €750 million is lined up this year for the health service. The centre cannot hold in the health service. Private health insurance is unravelling as thousands cancel it every week. The public hospital system cannot cope with the demand. This is what consultants, nurses and people on the ground are telling us.

The Deputy should put his question because he is over time.

It is important to put aside the spin and acknowledge that a dramatic intervention is needed. The Government needs to stand back from this, assess the crisis and then work out a proper pathway towards resolving it to ensure that as a minimum in difficult times we can provide a basic health service to our public and that operations that are needed are carried out.

At the end of 2012 there had been over 20,000 fewer people on trolleys than at the end of 2011. That was an improvement of 24%. Up to 5 April 2013, 2,600 fewer people had been on trolleys compared with the same period in 2012. There are strains on the health service, particularly at this time of year. We have come through a period of particularly unseasonable weather. Winter time and winter weather put additional pressure on emergency departments and on the hospital system.

The Minister is saying everything is fine.

Nobody is saying everything is fine.

The Minister for Health is saying everything is fine.

As I have said, in the health service there are always strains and demands and the question is how best to manage them. The Minister for Health and the HSE are managing as best they can. If the Minister needs to turn somewhere for advice on how to manage better it will not be to Deputy Martin because he, of all people, was not able to manage the health service in the best of financial times, when he was Minister for Health and had plenty of money available. He left a legacy of the HSE and mess that we are doing our best to clean up.

That is the usual argument.

The Minister will not turn to the Tánaiste.

The Tánaiste knew all the answers when he was on the Opposition benches.

The Minister will not be turning to Deputy Shortall. We all know where the Tánaiste stands in respect of the Minister for Health. He is four square behind him.

The Croke Park II deal, negotiated by the Tánaiste's party colleague Deputy Howlin, was overwhelmingly rejected by the public sector trade unions, many of which are affiliated to the Tánaiste's party. As a former trade union official and a lifelong union member the Tánaiste will fully understand that the nurses, teachers and firefighters who rejected the deal did not do so lightly. They did so because they understand that the deal was bad for them and for their families and for the public services on which we all depend and for our domestic economy. Yesterday, after its meeting, the Irish Congress of Trade Unions made it very clear that it would oppose any attempt by the Government unilaterally to impose pay cuts through legislation. Yesterday, the Taoiseach refused to say whether he would respect the outcome of the union ballot and he also refused to rule out legislating for pay cuts.

Will the Tánaiste, as leader of the Labour Party, respect the outcome of the trade union vote on Croke Park II? Will he, as a lifelong trade unionist, oppose any unilateral attempt to introduce pay cuts through legislation?

As everybody is aware just over two years ago this Government inherited the biggest financial and economic crisis ever to face this State. We determined that we would fix the problem. We have made a lot of progress in that respect. We are now 85% of the way there. There is a piece remaining to be completed, approximately €3 billion in savings in public expenditure. The pay and pensions bill of the State is approximately 35% of expenditure so we took the approach that a third of the remaining savings to be made in order to fix our problem should come from the pay bill.

In negotiations a set of proposals was developed which provided for reductions in pay for those employed in the public service at the higher end of the pay scale and some additional working hours for those on the lower amount of working time. Approximately 87% of employees in the public service who earn less than €65,000 would not have their core pay reduced under those proposals. We felt that the proposals were fair and reasonable but they have not been accepted in a ballot of trade union members. That is disappointing but it is a reality. It is also a reality that the savings must be made. A saving of €300 million needs to be made in the payroll this year, and €1 billion between now and 2015.

We now have to reflect on the decision made. We need to hear from the trade union movement about the reasons for the rejection of the ballot and the Government will have to consider those. It is important that we do not put at risk what has already been achieved. We are now seven months from exiting the bailout. If we had not done what we have done, and certainly if we had taken advice from Deputy Ó Caoláin's party, we would be seven months from entering a second bailout. This is a time when we should not put at risk what has been done, either by failing to complete what needs to be completed or by walking into conflict and confrontation. This is a time for calm, reasoned, reasonable reflection on the outcome of the ballot and that is what the Government will do.

Very clearly the Tánaiste has not taken the opportunity to give clarity on his and his party's position on the possibility of legislation to impose cuts in public sector pay. He has taken exactly the same position as the leader of Fine Gael. I am hugely disappointed because I fail to understand why he would continue to act as a crutch for a party whose policies he is assisting to implement and that are very bad for the interests of the ordinary people. I ask the Tánaiste again to make it clear that no Deputy of any party will be asked to vote in this House on a Bill that would further punish low to middle income public sector workers who have already taken major pay cuts and many of whom are struggling to pay excessive mortgages, to heat their homes, to provide for their children's education and for health care.

That is the reality we are in. I am talking about what the Tánaiste has taken as a fall-back position. Any time Sinn Féin asks him a question, he refers to fairytale economics. There has been a list of fairytales coming from him in recent times but the most clear one was Labour way's or Frankfurt's way.

It was not as bad as Sinn Féin's - the gun in one hand and the ballot box in the other.

That was surely one hell of a fairytale and the Tánaiste has come up with many more. I ask him to answer the question. Will he give an assurance that there will be no legislation to cut public sector pay further? The answer must be either "yes" or "no".

Hear, hear. Answer the question.

Deputy Ó Caoláin gives the Sinn Féin game away too easily.

Does the Tánaiste think so?

Sinn Féin wants to play politics with this and the party has wanted to play politics with this from the beginning. Its spokespersons were out condemning the deal before they had even read it and-----

Answer the question.

Will the Tánaiste not note that the membership of the trade unions have rejected it?

Will Deputy Ó Caoláin and his colleagues please allow a reply to the question he asked?

The Minister for Public Expenditure and Reform should be ashamed of himself.

Now, in the wake of the result of the ballot-----

The Tánaiste got it wrong.

The Minister for Public Expenditure and Reform should be ashamed of himself and he should resign.

-----Sinn Féin Members are more interested in how much of a hit they can score against the Labour Party than in either public sector workers or the interests of the country.

Answer the question.

Deputy Ó Caoláin said that I have some experience. Many of my colleagues in the Labour Party and I have some experience of dealing with these matters. Let me give him the benefit of that experience.

They have lost touch.

It is not the first time that an offer on pay or a proposed agreement has been rejected by trade union members.

That is because the Government threatened a 7% pay cut.

What happens when that happens is that the trade unions concerned talk to the employer - in this case, the Government - about the outcome of the ballot.

They are talking to themselves.

And the Government compromises.

Will Deputy McGrath stay quiet for a minute? Allow the Tánaiste answer the question.

An assessment is made of the reasons involved and thought is given to finding a way forward. The problem that the negotiations were aimed at addressing has not gone away. Deputy Ó Caoláin might want to wish it away. That is the kind of fairytale, fantasy type of economics Sinn Féin promotes.

The Tánaiste lived in a fantasy world.

The Tánaiste is the J.K. Rowling if that is the case.

Will Deputies settle down please and listen to the reply?

Sinn Féin might think it can go away but it will not go away. The reality is additional savings have to be made and that reality has not been changed by the outcome of the ballot. What will now happen is there will be calm, reasoned reflection on the ballot.

And more taxes will be introduced.

Will that be between the Tánaiste and Deputy Keaveney?

Will the Tánaiste answer Deputy Ó Caoláin's question?

The Government will consider what has to be done, and while we are doing that, Deputy Ó Caoláin might tell us whether he would legislate for the 100% cut on public service incomes in excess of €100,000 that Sinn Féin proposed.

I have never heard such nonsense in all my life but clearly the Tánaiste is in the Taoiseach's pocket and that is where I believe the vast majority of the Labour Party do not want to be.

We miss the Deputy.

The Labour Party has been in power for two years. It has been resoundingly rejected by the people of Meath East-----

The Deputy did not do too well herself either.

----and now decisively rejected by the organised movement of working people, a union movement led in many instances from the ranks of the Tánaiste's own members who valiantly battled for him to try to convince workers of the merits of his attack on their wages and conditions, but who failed utterly. An overwhelming majority of workers stood up to the Government parties' threats - threats, incidentally, enthusiastically championed and broadcast by their friends in the media - and yet workers faced them down, which was an act of defiance that has served as a shot in the arm for all of their victims, including lone parents, disability payment recipients, home owners and pensioners, because public sector workers demonstrated that there are a lot more of them than there are Government Members. They debunked the myth that it is not possible to take on the Government. The reason for their defiance is simply that there is no more blood to be taken from that stone. How could it be otherwise when a majority of public sector workers who earn between €23,000 and €45,000 a year have endured a 22% pay cut and the Government wants to impose more on top of that?

That is completely untrue.

Where is the Government going? The labour and trade union movement was built on solidarity and sacrifice. The ambitions of people like Connolly and Larkin were not just about defending wages and conditions but also about developing a vision of a better society which puts the interests of ordinary people first. The Tánaiste has completely failed and abandoned that tradition.

More than 100 years ago in Wexford, the constituency of the Minister for Public Expenditure and Reform, future Labour Deputy, Dick Corish, led a strike of 700 workers at Pierce Foundry. It was a titanic strike for six months that won union recognition during which workers were bludgeoned on the streets. What would these self-sacrificing heroes think of the Minister? What would Dick Corish think of his county man, Deputy Howlin, imposing pay cuts of 7% at the behest of international financiers?

Since the Tánaiste does not believe in struggle and solidarity, is it not time he did the honourable thing and followed the path of the tradition that he is firmly in and, like Michael O'Leary before him, go off and join Fine Gael and bring the Minister for Public Expenditure and Reform with him?

The Minister is there already.

The Deputy is well briefed on the Wexford situation.

The Labour Party has always stood for, and stands by, working people.

This is the Dáil, not a comedy show.

Fianna Fáil Members are in no position to laugh after the condition they left the country in. Whatever they do, please do not add insult to injury. They left the country in ruins. Please do not scoff at what they have done or at the job we have done to restore the country.

Will Members please stop this nonsense and allow colleagues to ask questions and hear the answers?

I have not said a word. The Tánaiste is too precious about himself.

The first thing that working people need is a job and that is why we have to fix this country's economy, its reputation, its banking system and its finances in order that we will get the investment in the country to sustain jobs and to create more jobs.

Second, the Labour Party has always believed in decent public services in this country and in access to health and education and the other public services we need, but in order to have public services,one has to able to pay for them. One cannot live in a fantasy world or a world of fairytales where somebody else will pay for them-----

When did the Tánaiste realise that?

-----and that is why we have to fix the state of the public finances we inherited in order that public services can be ensured into the future and in order that those who work in our public services and whom we respect can have the job security they deserve.

With less money.

The Government put a set of proposals developed in negotiations with the trade unions. Those proposals have not been accepted. We now need to look at this situation with the trade unions that represent those employees. It is a time for that to be done in a calm and reasoned way and it is not a time for Deputy Daly or anybody else to play politics with it.

The Tánaiste has become so indistinguishable from Fine Gael that he does not answer questions in the same way. The reality is people have clearly rejected the Labour Party and is it any wonder?

More than 13,000 full-time jobs were lost last year and youth unemployment stands at 27%, despite the fact that 1,600 young people are being driven from these shores every week. The Government speaks of alternatives, having put forward a deal which left low paid workers facing cuts in pay of between 3% and 11% on top of cuts they have taken in each of the preceding years-----

The Deputy should tell the truth.

-----while those at the top, including former Ministers on pensions of €135,000, were asked to take a 5% cut. Alternatives have been clearly outlined. The problem for the Tánaiste is that he must try to spin the fairytale of "Eamon in wonderland", a place where it is possible to magically squeeze blood from people who have nothing else to give. That is the message the Tánaiste has been giving. The vote by the trade unions is a turning point as he and his backbench Deputies know. I will ask the latter a question over their leader's head. Will they try to cover their tracks to protect their seats-----

The Deputy should put a question.

-----or will they join the ranks of the real opposition that is growing outside, while the Tánaiste stays with his friends?

(Interruptions).

I will suspend the sitting rather than ask Deputies to be quiet again. I am serious about this; the interruptions must stop. Please allow the Tánaiste to answer without interruption.

This country has a huge problem of unemployment. It is not true, however, that the number of people at work reduced last year; it increased.

Mainly through part-time jobs.

I am not-----

The Tánaiste should ignore interruptions.

There is a huge problem of unemployment. The Government inherited a very big, deep financial problem when it was elected. When one has problems of such a scale one can either rant and chant about them, as Deputy Clare Daly does, or one can try to fix them, as the Labour Party entered government to do and is doing. Let us take the issue of youth unemployment. The Deputy is correct that the level of youth unemployment is much too high. Far too many young people coming out of college and university cannot find the type of employment their qualifications justify. One can either shout slogans about this or try to solve the problem. The Labour Party placed the idea of a youth guarantee on the agenda of the European Union and succeeded in negotiating a package of €6 billion to support the guarantee and enable us to put in place practical measures to resolve these problems. This is the reason, for example, that we work so hard to try to attract investment to this country and provide employment for young people coming out of college.

It is remarkable that one can go through constituency after constituency and one will find the ultra left opposing every single proposal for industrial development or the location of industry. In my constituency, for example, a proposal by a company to provide additional employment is being actively opposed by Deputy Daly's colleagues on the benches opposite. The Deputies cannot have it both ways. They cannot chant, rave and shout slogans about youth unemployment and then oppose every single measure that is taken, whether to correct the public finances or locate a particular industry in a particular area to try to solve youth unemployment.

What is the project?

The Tánaiste should name it.

While Deputy Daly and I share a concern about the level of youth unemployment and the problems of working people, the difference between us is that she shouts slogans at problems whereas I work in government to try to solve them.

We should give the Tánaiste a medal.

The Government is taking money out of the pockets of workers.

(Interruptions).

Deputies are continuing to make a show of the House by shouting. I ask them to allow the Tánaiste to present the Order of Business.

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