Gerry Adams
Question:4. Deputy Gerry Adams asked the Taoiseach if a meeting of the Cabinet committee on health took place on 12 December 2016. [40126/16]
View answerWednesday, 18 January 2017
Questions (4)
Oral answers (24 contributions)
The Cabinet committee on health did not meet on 12 December 2016. However, it did meet on 13 December 2016 and 11 January 2017.
I thank the Taoiseach for clarifying that the committee met on 13 February rather than 12 February. Having established that meetings took place, I will ask the Taoiseach about the content of those meetings. As we all know, despite the Government's trumpeting about increased funding to reduce waiting lists, including the resurrection of the National Treatment Purchase Fund, the numbers of people waiting in emergency departments and on waiting lists for treatment in the hospitals have increased. According to the Irish Nurses and Midwives Organisation, the trolley numbers last November were the worst since records began. Over Christmas and the new year, the position got even worse, with the numbers of people on trolleys exceeding 600 at times. Every day was a crisis in this regard.
The Minister for Health, Deputy Simon Harris, announced the winter initiative last September. When we raised concerns at that time the Minister claimed the Health Service Executive was sufficiently resourced to deliver on its service plan. All the evidence flatly contradicts that assertion. Does the Taoiseach accept that, in the absence of meaningful engagement with trade unions and, crucially, front-line staff and medical professionals before ministerial announcements and governmental fanfare, the Government is destined to deal with crisis after crisis on an ongoing basis?
In addressing the general issues, I also ask the Taoiseach to comment specifically on mental health. The absence of 24-7 crisis intervention services is causing an ongoing crisis and costing lives across the country.
As we are discussing a Cabinet committee, I do not expect the Taoiseach to give explicit detail of what was discussed at its meetings. He will recall that I attended many Cabinet committee meetings on health in the past five years.
I was struck by the intervention of Deputy Seán Barrett this morning. All of us, particularly those in opposition, can focus on the failings of the health service. What we need, however, is some form of accountability. If we are expending the bones of €20 billion on health services, why do we not have a better health service?
What happened in recent weeks was highly predictable because it happens every year and preparations had been made. A winter initiative was announced in September and a waiting list initiative was funded and prepared. In addition, the expansion of the fair deal scheme was supposed to meet the full demand for fair deal places and ensure nobody spent time in hospital if he or she should not be in hospital. Additional home care packages were also announced in advance of the Christmas recess. Despite this, the pressure on accident and emergency departments has been unprecedented this year. How has this occurred? Is anybody responsible or accountable? That was the fundamental question asked by Deputy Barrett this morning.
Having also attended the meeting of the Committee on Budgetary Oversight yesterday, I was disappointed at the amount of information made available to the committee, contrary to what was promised.
In regard to health, the amount provided in respect of the overspend on health is €782 million, which, as pointed out earlier by Deputy Seán Barrett, is an astonishing amount. Less than a couple of weeks after we received that information, the chief executive of the HSE told us that if we were going to have a functioning health service a further €9 billion would be required over a number of years.
Like the Taoiseach I have attended many Cabinet sub-committees. There are five Ministers attached to the Department of Health and numerous public servants in that Department and in the HSE. I have attended meetings of the Cabinet sub-committee on health at which there were so many people trying to gain access one could have sold tickets for them. As I said, the chief executive of the HSE has stated that on top of the current €782 million spend on health services an additional €9 billion is needed. In the context of the Budgetary Oversight Committee, is it possible for Members to be given more details on the health spend such that we can find out what is happening to people's hard earn taxes, USC contributions and so on? They are paying to fund provision of a proper health service that does not allow elderly, sick people to remain on hospital trolleys indefinitely, which is something we all want.
In regard to Deputy Burton's statement that the demand to attend the health sub-committee a number of years ago was so high they could have sold tickets for it, the Labour Party was in a position to do something about that but it did nothing.
Like what? Fianna Fáil destroyed the country and left it broke.
The Labour Party did nothing.
In recent years, the Cabinet sub-committee on health has played a damaging role in the health service. It has been confirmed many times that it is a forum through which members of Government have interfered with the HSE's annual plans in order to cover up pressures. What they have done is over-promise and under-deliver, evidence of which we saw in December last. On many occasions my colleague, Deputy Kelleher, Fianna Fáil Party spokesperson on health, raised the issue of overcrowding and the trolley crisis in our hospitals and the Government's plan to deal with those issues during the winter. On each occasion Deputy Kelleher raised that issue the response of the Minister for Health was that there was no cause for worry as the Government had extra money available to it and the winter initiative would solve all problems. What happened last December? We had the highest ever number of people trolleys on record.
I agree with the comments made earlier by Deputy Seán Barrett, who is a member of Government side of the House, that putting more money into a service with no accountability is not the answer. The reason there is no accountability is that at the top of the equation there is political interference in the HSE plan to keep people on board.
The Deputies were demanding political interference every second day.
Deputy McDonald is wrong when she says that the waiting lists are worse than ever. This morning, according to the HSE TrolleyGAR system there were 388 on trolleys which, although it represents a reduction of 10% on the figure for the same day last year, is still too high. Trolley numbers remain a significant concern. There are hospital pressures today in Kilkenny, Drogheda, Portlaoise, Mullingar and the special delivery unit of the HSE is monitoring these sites and providing the support to the system that is needed.
Everybody is aware that more money than ever is being pumped into the health system. We should not decry the good and progressive work that is being carried on in so many hospitals by many medical personnel. People who have been through the system are very complimentary of the treatment they received. I accept there are pressures, some of which are the result of referrals to hospitals when the system is blocked up. I made the point earlier to Deputy Seán Barrett that we are building many primary care units around the country, the objective of which is to ensure that people do not have to go to hospital in the first instance. The Minister, Deputy Harris, has spoken of the urgent need to agree a new contact with general practitioners. I understand that the current contract has been in place for many years.
Deputy McDonald is incorrect in her statement today in respect of the number of patients on trolleys. I admit the numbers in this regard are too high but they have improved. Deputy Howlin asked the important question of whether anybody is being held responsible for this. The Minister has written to all of the line managers in the hospitals in regard to their responsibility, following acceptance of the HSE proposition and more money than ever being pumped into the system, to stay on budget. As the Deputy will be aware, there can be no further supplementary budgets in the course of a year. The winter initiative is an important element and €40 million has been put into it to help reduce delayed discharges, which have reduced from a high of 659 in early 2016 to less than 500. The HSE has exceeded the target in terms of the number of delayed discharges nationally, which stood at 464 on 10 January last and stands at 388 today. The Minister meets on a regular basis with HSE senior personnel on these issues.
As all Members are aware, difficulties arise in the health service at particular times, be it in regard to medical cards, orthopaedic services and so on. Many of our older hospitals need serious injections of capital to bring them up to standard. I hope that this can happen following the evolution of the hospital groups into hospital trusts such that people can make decisions about what we want in a country in which there will be 1 million more people in the next 20 years. Every year, 20,000 people in this country pass the age of 65, which means that in the time ahead more people will require care and attention in the community, home care packages and hospital, respite and palliative care and so on. There is a very heavy programme of work ahead for the next 15 to 20 years. It is for this reason the Minister, Deputy Harris, is adamant that we should have agreement at least among politicians here on a ten-year programme in terms of the big decisions that will have to be made in the future. Despite that billions of pounds pumped into the UK National Health Service, NHS, the headlines in Britain in terms of its health services, are the same as they are here, with very trenchant views being expressed.
The Minister, Deputy Harris, is monitoring the situation and is working closely with the HSE and medical personnel to improve the lot of patients who have to avail of our health services. We should be very proud of our service such that in cases where it is first class it is deemed so. I accept that there are problems in terms of the layout of some of our emergency departments. I also understand that in terms of the new emergency department at Wexford layout is not an issue.
It is a wonderful facility.
The Deputy certainly looked after Wexford.
A number of weeks ago there were no people waiting on trolleys in Beaumont Hospital despite that previously it had one of the highest number of people on trolleys.
We need a new emergency department in Mullingar.
Of course, We have had all of the rows about need in Mullingar, Tullamore, Portlaoise and so on over the last 40 years and they continue. When one has to make major decisions in respect of hospitals one understands the consequences of these things. We need a ten-year programme to identify what we want in various locations around the country, including what type of services should be provided and so on so that people can get the very best attention and treatment in terms of their needs. For now, more money than ever is being pumped into our health service. The Minister has notified line managers of their responsibilities to stay within budget. Hopefully, things will improve as the year goes on.
In regard to the Taoiseach's statement that in terms of the trolley count the situation has improved on what it was before, one would think that he means they have improved on what they were in the dim and distant past.
He means it is better than last week and better than over Christmas. That is the recent past. What I am trying to understand is the extra value the sub-committee brings to bear. It seems we are going around in circles, with the Taoiseach in a state of denial over just how serious circumstances are. Does he make decisions? What influence has he on the Minister for Health and his decisions?
The Government decides on the basis of the moneys available to it to allocate to Departments. This year, 2017, more than ever before has been allocated to the Department of Health and the HSE to provide a range of services across a very broad spectrum for people all over the country. Parallel to that, we are working with some of the Ministers who were mentioned in respect of the mental health area, where money has been provided, and in respect of the prevention of illness, a healthier Ireland and a more conscious Ireland. These are all elements for all our people. More than ever before is being pumped into the health area now.
Did the Taoiseach not hear my question?
Some very beneficial and good systems are being put in place.
That is fantastic but it does not answer my question.
We still have quite a distance to travel.
Does the Taoiseach influence the Minister's decisions?
The Minister, Deputy Harris, is working extraordinarily hard at his job and will continue to do so.
That is not what I asked either.