Confidence in the Minister for Health: Motion

I move:

That Dáil Éireann has no confidence in the Minister for Health, Simon Harris T.D., and calls on him to resign from his Ministerial position forthwith.

The submission of this no-confidence motion was not rushed. It is not vindictive or personalised. This motion was submitted because of the scandal of the national children's hospital, with the overspend representing for us the final straw. There are those in the Minister's own party and the media who say they believe this motion is unfair. When I hear that, I wonder if they have been living under a rock for the past three years or are being deliberately obtuse or just partisan. There are those who say that this motion will not build a hospital, reduce a waiting list or get a patient off a trolley, but let us face it - nothing that the Government is doing is achieving those aims either.

We are not going to stand on the sidelines and let the Government off the hook for failing repeatedly to deliver and for presiding over a significant waste of taxpayers' money. We were elected to stand up and give voice to our constituents. At least we are using our voices, unlike the men and women of Fianna Fáil who proved themselves incapable of understanding political accountability when in government and who are now showing that they either do not understand political accountability or are afraid of it. What we in Sinn Féin are seeking to do is to do what is right in the service of political accountability and the future of our health service.

The national children's hospital overspend is not an isolated incident. It is another in a series of scandals, mistakes and failures that have blighted the Minister's term. He will stand up in a few minutes' time and list off what he sees as his achievements, but they pale into insignificance against the failures he has presided over for almost three years. He tweeted today about the repeal of the eighth amendment and the passing of the Public Health (Alcohol) Act 2018, but he did not do those things alone. To try to claim credit for the decades of hard work by pro-choice campaigners is more than a little bit sad. Even his most ardent supporter could not defend his record in good conscience. How can anyone defend record-breaking levels of patients on trolleys? How can anyone defend failed scoliosis action plans? How can anyone defend chronically understaffed child and adolescent mental health services, CAMHS?

How can anyone defend a 27-week wait for the results of cervical smear tests? How can anyone defend record-breaking waiting lists totalling 1 million patients? How can anyone defend forcing nurses and midwives onto the streets to strike for safe staffing? How can anyone defend the Minister's role in the CervicalCheck scandal? How can anyone defend the recruitment and retention crisis across the front line of the health service? How can anyone defend thousands of children waiting years for speech and language therapy or for occupational therapy? How can anyone defend hundreds of older people waiting months for home support services? How can anyone defend the crisis created in general practice? How can anyone defend the spending of €2 billion on agency staff in eight years?

How can anyone defend misleading the Dáil? How can anyone defend knowing of a catastrophic overrun on a capital project and doing nothing about it, saying nothing about it, and actively keeping it from colleagues? How can anyone defend the withholding of and the drip-feeding of information to Deputies and Dáil committees? How can anyone defend reappointing a board which was presiding over the meltdown of the children’s hospital project without seeking any advice on the performance of that board? How can anyone defend an expected cost overrun on the national children’s hospital of €450 million? I could go on but I only have five minutes, not five hours. The simple fact is that nobody can defend it - no one except the Minister and the opportunistic cowards in Fianna Fáil.

It is incompetence and a lack of ability which have brought us here today. Past performance is, I believe, an indicator of future performance, but the Minister's past performance makes me certain that he is not up to the job of being Minister for Health. He is out of his depth. How can we, in good faith, in addition to all the other failures and the gross level of incompetence and impotence displayed by him as Minister in his handling of the national children’s hospital, say that we are confident that he is the person to lead the health service? We cannot and we will not.

The overrun at the national children’s hospital materialised on his watch and under his nose, but there was another person involved further back in this project whose role in this cannot be ignored. Who agreed to the doomed two-stage procurement strategy just for political expediency so that he or another Fine Gael Minister could cut the ribbon? It was the Minister's predecessor in health, the Taoiseach, Deputy Varadkar. In 2014, it was recognised in a procurement strategy report that this approach was untested in the State and that it carried significant risks. That report stated that added pressure would be put on the project’s design team which could lead to a poor quality price.

All the available evidence pointed out that we would be where we are today, yet the Taoiseach, Deputy Varadkar, the politician who governs by optics, took a decision so the ribbon could be cut early. He did not do this for the children of this State; he did it for himself and for Fine Gael, and on the Minister's watch, he continued in exactly the same vein.

If the tables were turned and if I or any other Opposition Deputy who was in his shoes and had presided over the litany of scandals he has presided over, would he vote confidence in us? There is not a snowball's chance in hell that he would and there is not a snowball's chance in hell that we will vote confidence in him.

Our healthcare system is in crisis as every day brings new headlines which tell of the litany of failures inherent in the system. We have had a series of scandals, including that of CervicalCheck. Over the course of that debacle, the bravery of women like Emma Mhic Mhathúna has shone a light directly on the incompetence of the Minister for Health. That scandal continues with the backlog of tests and a wait time of seven months for results. We have a children’s hospital with runaway costs, up to €0.5 billion over budget, money that will have to come from taxpayers and from other capital projects. For this Minister, this Government and Fianna Fáil, patients on trolleys is the norm. It is acceptable to them. It is so acceptable that the Minister deemed it appropriate this afternoon to take to Twitter to puff out his chest and declare: "Bring it on".

The Minister is failing. That is very clear. Every day Deputies from across the Chamber get to their feet to set out the latest crisis. Even Fianna Fáil does it, even Deputy Micheál Martin does it, albeit to throw shapes and play to the camera, but when the camera is off, it is business as usual for Fianna Fáil.

Supply and confidence has undermined and discredited the political process. The essential role of the Opposition is to hold the Government of the day to account, to advocate for those without a voice, to call out failing Ministers and failing policies and to demand better, but Fianna Fáil, in its supply and confidence agreement, has abdicated responsibility and betrayed the electorate.

The simple fact is that the Minister is incapable of doing his job, yet he remains in office. He believes he is untouchable. The crisis and scandals mount and hardworking people pay the price, quite literally.

The leader of Fianna Fáil has listed the failings of the Minister for Health but by his actions, he will support him, he will protect him and Fianna Fáil will protect Fine Gael. The leader of Fianna Fáil says he will support the Minister in the national interest. Let me tell him that it is never in the national interest to keep a failing Minister in place. The price is too high not only in terms of the children’s hospital but in hospitals and doctors’ surgeries across the State.

The leader of Fianna Fáil tells us that this is done to avoid an election as Brexit looms. The Taoiseach has said there will be no election before Brexit. There is no threat of an election, yet the Minister remains, and all this because of so-called supply and confidence, a deal that covers the blushes of a Fianna Fáil leader for giving the Government a blank cheque while pretending to act as an Opposition. Sleeveen politics is now the order of the day in the Dáil.


This is a coalition in all but name.

The Taoiseach certainly has the measure of the leader of Fianna Fáil because he knows that Deputy Micheál Martin will fall into line once pressure is applied. This is not about Brexit. This is not about avoiding an election. The national interest is not served by retaining a Minister who is clearly failing.

Today, supply and confidence is exposed. It is not about stability; it is about stagnation. It is a grubby deal by the political establishment to control both Government and Opposition at the same time. Its legacy is seen on waiting lists, on trolley counts and in families struggling to make ends meet.

The question to Deputy Micheál Martin is a simple one. Does he have confidence in the Minister? He either does or he does not. An abstention is a confidence vote in the Minister and a con trick on the people. Unfortunately, this evening we will witness political cowardice and hypocrisy of the highest and of an unparalleled order.

There are 1.73 billion reasons not to have confidence in the National Paediatric Hospital Development Board. Those are not my words but the words of the Fianna Fáil health spokesperson, Deputy Donnelly.

Deputy Stephen S. Donnelly

Thanks John.

There are 1.73 billion reasons not to have confidence in the Minister with ultimate responsibility for what Deputy Donnelly calls the mugging of the Irish public to the tune of over a billion euro.

This will make East Coast FM.

That Minister is Deputy Harris.

The Wicklow boy.

Our health service is in crisis. Some 442 people are lying on trolleys throughout this State. That is despite numerous guarantees that this would end. Half of the new hospital beds promised for winter are still not open, and that includes eight in St. Columcille’s Hospital. Our GPs are protesting, we have had the cervical cancer scandal and the list goes on.

Putting out statements by the dozen criticising the many problems within the health service will not fix those problems over which the Minister, Deputy Harris, presides. Keeping him in office will not solve the many problems. It is quite clear he is completely out of his depth.

The real national sabotage is sitting on the fence on this motion of no confidence and keeping the Minister for chaos in office and ensuring accountability and the possibility of change are just words in the view of Fianna Fáil.

The Fianna Fáil spokesperson for health, Deputy Donnelly, previously asked the question as to why no one has been fired for the huge cost increase in building the national children’s hospital. The answer to that question lies firmly in the hands of Fianna Fáil.

It is now time for Fianna Fáil to put up or shut up on this issue, once and for all.

I put it to the Minister, Deputy Harris, that this no-confidence motion is every bit as much about his predecessors, the current Taoiseach, Deputy Varadkar, and Senator James Reilly, as it is about him. It is first and foremost about Fine Gael's ideology towards healthcare delivery and citizens' entitlement to it.

The HSE, as it stands, is not fit for purpose. Fine Gael said this in 2011 in its five-point plan. It said it would eliminate long waiting lists and end the unfair public-private two-tier system to replace it with universal health insurance system. Eight years later these words ring very hollow for all those who have suffered, are suffering and will continue to suffer in this shambolic health system. It is too late for those who have passed on, specifically Emma Mhic Mhathúna and other brave women.

Recent and current issues I am working on, which have proved to me why I should have no confidence in the Minister and in the Government, include: the cervical cancer scandal; the urgent need of approval of Spinraza; the in loco parentis clause; the unprecedented waiting lists for children for the assessment of needs; the impending closures of services for the Irish Deaf Society; the failure to ratify the optional protocol to the UN Convention on the Rights of Persons with Disabilities; and proposed cuts to staffing levels in all the major disability umbrella organisations. It is not only the major issues. I also add the commitments the Minister, Deputy Harris, made to me personally and reneged on, including his agreement to meet representatives of Debra Ireland who advocate for children who suffer from epidermolysis bullosa, EB.

That five-point plan also stated that hospital funding would be radically overhauled so the money would follow the patient. Something radical has certainly taken place. There has been a radical increase in the cost of the national children's hospital from the figure the Taoiseach, Deputy Varadkar, said would be €650 million, to the current €1.5 billion with an inevitable further increase.

I have no confidence in the Minister, Deputy Harris, to deliver for people or for patients and I have no confidence in his Government.

In reality this motion is a statement of fact. Dáil Éireann has no confidence in the Minister for Health. Procedurally, it will be a relatively tight vote in any event. All the evidence suggests that the vast majority of those abstaining do not have confidence either. The Fianna Fáil Deputies will cry "Brexit prevents us from doing anything," even though practically every statement they make implies that the Minister should go. Deputy Donnelly lists the myriad failings practically daily. Brexit does not and cannot mean that this Government and Ministers get a free pass and a blank cheque in the meantime. That is what Fianna Fáil and Deputy Micheál Martin are facilitating here. By rights the Taoiseach should recognise the failings himself.

It is the role of the Opposition, and it appears all the Opposition parties agree, to hold the Government to account as Fine Gael used to do when it was in opposition. It tabled or supported a motion of no confidence in the Fianna Fáil Government at a minimum once a year between 2004 and 2011, and rightly so. Some of those Ministers were as bad as the current Ministers.

This motion is not about an election. It is about a crisis in health that gets more and more out of control each day with record waiting lists, the Government exacerbating and drawing out a dispute with nurses and, most specifically, a €450 million overrun in the national children's hospital. Despite what the Taoiseach said, this overrun will have real implications for major projects in health and elsewhere.

My colleagues have adequately outlined the many reasons Deputy Harris should be removed as Minister for Health. Unless some Fianna Fáil Deputies manage to grow a spine in the next half an hour, the Minister will stay in position with their blessing and under Deputy Micheál Martin’s instruction. Why would Deputy Micheál Martin want to keep Deputy Harris in the position? Why does he not want accountability? Maybe it is because he simply does not believe in accountability.

This is Deputy Micheál Martin’s 30th year in the Dáil. Over that time he stood firmly with former Members Charlie Haughey and Bertie Ahern as evidence mounted over corrupt payments. He did not seek accountability then and he does not seek it now. During his 14 years as a Minister, time and again, he ducked and dived, avoiding accountability at every turn. When asked if he bore any responsibility for the illegal nursing home charges scandal, which cost the State €486 million, he said "No, I do not". There is also the issue of his cronyism in appointing board members to the Irish Blood Transfusion Board at a critical juncture when public confidence was shaken following the hepatitis C scandal. Then there was the overseeing of the FÁS expenses scandal when despite being aware of a gross waste of public funds he took no action to stop it.

What has this got to do with the Minister, Deputy Harris?

What about the €6,000 you got in 2004 and the €1,600-----


The comparisons with recent scandals involving the Minister, Deputy Harris, do not need to be expanded on. In each case, Deputy Micheál Martin blamed others. He blamed officials, civil servants and advisers-----


-----but he never took responsibility for these scandals as Minister. The simple reality is Deputy Micheál Martin does not believe in accountability in public life nor does Fianna Fáil. His primary legacy is the HSE itself, a body he established, in which he managed to translate his personal failings into an institution with systemic failings. This body continues to affect every man, woman and child in the State and is an organisation behind which every Minister of Health since has hidden when they come into power.

The motion we are debating tonight seeks to hold the Minister, Deputy Harris, to account for his failures. He may, however, quite reasonably look across the Chamber at Deputy Micheál Martin and others as the source of many of his current woes. Tonight it looks like Fianna Fáil will again help to provide cover for a failing Minister. It will again scupper attempts by the real Opposition to provide accountability in Irish public life.

It does not sound like it.


The Minister, Deputy Harris, should go but so too should Deputy Micheál Martin. It is time for accountability and it is time to realise that the people deserve better.


Can we have some order for Deputy Ellis?

It is hard to know where to begin with the failures of the Minister. Many have already been outlined in detail by my colleagues but I wonder if the Minister is paying attention to what people are saying. If his tweets this morning show anything it is the same old arrogance of this Government propped up by Fianna Fáil. The Minister tweeted "Bring it on" about a debate on a vote of no confidence in him. This is the height of arrogance. One would think that with so many documented failures in the health service, for which he is directly responsible, the Minister would have shown a little humility. I would like the Minister to come to Dublin North-West to show that same arrogance to the elderly, to mothers and to the disabled-----

The Deputy's time is up.

-----to listen to what they say. In his arrogance, the Minister tried to manage the news around the catastrophic failure of the overspend on the national children's hospital.

The Deputy's time is up.

The Minister must not try to shut down debate throughout the country on the cost of this overspend to local communities.

Deputy Ellis should practise what he preaches.

How dare the Taoiseach suggest that those who raise concerns and fears that health projects in their areas will be delayed or not go ahead are being unscrupulous or insincere? I am sincerely concerned that health projects in my constituency-----

Because you delayed them.

Deputy Ellis's time is up. Will he please resume his seat?


It was because of the incompetence of this Minister for Health. I will not stop raising concerns and I will not have the Taoiseach or his Minister accuse me of being unscrupulous for looking after the interests of my constituents.

Will the Deputy resume his seat, please?


Could all Members please just calm down a little bit?

Without a doubt, being the Minister for Health is one of the toughest jobs in government.

You ran away with it.

He ran away with himself.


It is also one of the most important jobs in the country because it affects so many lives. It is also good experience for higher office. It helps one to understand what a crisis is and what it is not and how to deal with many at the same time.

One after the other.

It is noteworthy that three of the four main party leaders in the Dáil are former Ministers for Health. The other Member who is proposing this motion has never held ministerial office and has no real understanding of the day-to-day dilemmas faced by Ministers-----

What about policies?

-----whether it is being pressurised to act before one has full and accurate information, or being expected to make decisions before one has the time to consider all the options, and having to choose between two or three imperfect choices, knowing full well that no choice will satisfy the critics.

If the Deputies in Sinn Féin had any real experience of running a country, Department, large organisation or even small business, they would not be so trigger happy with their no-confidence motions. This is the sixth in half as many years.

And four of them are gone.

I have confidence in the Minister for Health for many reasons. He is getting things done, including a successful referendum on the eighth amendment, the Public Health (Alcohol) Act and, after years of little investment, three national hospital projects under construction with a fourth due to go to tender in the foreseeable future. Free GP care has been extended to all carers and medical cards have been provided to all children with a severe disability, regardless of their parents' incomes. The HPV vaccine for boys and improved patient outcomes in cancer, stroke, heart attack and cystic fibrosis are other developments. Even in the toughest areas, such as the number of patients on trolleys, the Minister has made measurable progress. While there are still far too many, the number is at its lowest in three years in 2019 thus far. In January, the number of patients waiting more than three months for an operation or procedure - the Sláintecare target - was at a four-year low. While we have lost some ground due to the recent strikes, we will regain it. The Minister has handled difficult and emotive issues, such CervicalCheck or securing funding for cystic fibrosis treatments like Orkambi, with the utmost sensitivity. He invests enormous time and energy into gaining the confidence of patient representatives and, if supported, there is much more he can do in his post.

I also have confidence in the national children's hospital project. Major errors were made in calculating the true cost of building a hospital of this scale and complexity and, as Head of Government, I take collective and personal responsibility for that. However, I do not accept that it is wasteful expenditure. It is a project which is well under way. The first phase involving the satellite centre in Blanchardstown will open to patients this year while the satellite centre in Tallaght will begin construction this year and open in 2020. At the St. James's site in Dublin 8, stage 1 is almost complete and stage 2 has commenced. After decades of promises and false starts, the children's hospital is finally being delivered. Of course, we will do all we can to ensure the project gets back on track and is delivered on time and in line with the revised budget. We will work to ensure the hospital is commissioned no later than 2023.

I also have confidence in Project Ireland 2040. One year after its launch, many projects are coming in on time and on budget. Shovels are in the ground and the work is being done. All over the country, one sees the vision of Project Ireland 2040 being realised. Last week, we turned the sod on the new runway at Dublin Airport, which is our gateway to the world. The runway was promised for decades but it is now under construction.

Will that take long?

On Friday, I will be in Sligo for the sod-turning to mark the construction of the N4 Collooney to Castlebaldwin road, another project which was promised for decades and is now under construction. The same story can be told in every county. Taxpayers' money is being well spent on investments in the future. Only last week, €64 million was allocated to towns and rural areas.

They are being closed down.

Schools, community nursing units, third level institutions, primary care centres, tourism projects and sporting facilities are being funded.

We hear a great deal about accountability in the House. At its simplest, accountability is about taking responsibility and answering for one's actions. Accountability does not mean giving in to the baying mob, the thirst for bloodletting and a head on a plate every other day. A baying mob does not provide answers or solutions.

That is a terrible thing to call the public - a baying mob.

We saw that in November 2017 when Sinn Féin put down a motion of no confidence in the then Tánaiste, Deputy Frances Fitzgerald, accusing her of being at the centre of a scandal. Sinn Féin made false claims that were subsequently discredited, yet we have had no apology from its members for that.

It was also true when Sinn Féin tried to weaponise homelessness and personalise the debates around housing against the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy. It was true when Sinn Féin Deputies made false claims in the House about former Members having offshore bank accounts. Again, there has yet to be any retraction or apology for those false claims. We are seeing more of that practice from the Sinn Féin Party again today. It is easy and cowardly to throw rocks, but it takes courage to put one's reputation on the line and to build something lasting and better. Deputy Harris has the courage and the competence to succeed as Minister for Health and he deserves our support.

On this very day last year, the House concluded statements on the report of the Committee on the Eighth Amendment to the Constitution. That and all the work in between form an example of what we can achieve when the House works together. It is an example of how much more could be achieved if time in the House was better spent. Sinn Féin, however, does not change. To the ballot box and the Armalite, it has added the soap box and the no-confidence motion. Its stock in trade remains competitive anger and cultivated division. Devoid of ideas, its contribution to the Chamber can best be measured in decibels. It is no wonder that anyone expecting anything new of different from Deputy McDonald's leadership has already lost hope. I reject her politics of division. My politics is to deliver by working across parties, inside and outside the House. It is to work together.

Together, we repealed the eighth, passed the long-awaited Public Health (Alcohol) Act and made a massive difference in the lives of citizens with cystic fibrosis through access to new and innovative medicines. I am the first to acknowledge that there is a great deal more to do and I want to get on with that job. We are already working towards eradicating cervical cancer. Sinn Féin claims to speak for these people but truly it does not. It is our national aim to eradicate cervical cancer. This year, we will extend the HPV vaccination programme to boys. Our country is being watched internationally for our work on reversing the decline in the uptake of the HPV vaccine among girls. We can and will do more. We must bring to a conclusion talks with GPs on the delivery of new services and, more importantly, ensure their sustainability. We will move forward with the patient safety Bill to introduce mandatory open disclosure. We will overhaul our laws on organ donation to save more lives by replacing antiquated legislation with a new human tissue Bill. We will move forward with the assisted human reproduction Bill and get it passed this year to support families seeking to access IVF treatment. Most importantly, we are putting in place the plans and structures to take petty politics out of healthcare by implementing Sláintecare to transform our health service for once and for all.

Every deadline has been missed.

The Government will build the national children's hospital after decades of debate and get to the bottom of what has gone wrong. We will ensure that lessons are learned. We will not walk away from this vital project, however. Sinn Féin walks away. It walked away from the health ministry in Northern Ireland when it held that position. Sinn Féin might quit but quitting is not in my DNA. Walking away is not an option.

The Minister walked away from Fianna Fáil when he was in it.

I know Sinn Féin is used to gagging its opponents but we do not do that in here.

Deputy McDonald was also a member of Fianna Fáil.

Political accountability is about standing by one's decisions. It is about working day and night to deliver them. Leadership is about sticking with the job, even when the going gets tough and even when Sinn Féin tries to make it tougher. I accept both challenges.

As time is short, I will make just two points. The first is that I have worked with Deputy Harris around the Cabinet table for a number of years now. In many ways, he has the most difficult job in government. I have seen him fight for patients and those who need the health service to work. I have seen him deliver at budget time. Ireland is now spending more on healthcare than ever before. I have seen him bring people together on one of the most divisive political issues we have ever had to face and successfully pass a referendum proposal. I have seen him bring people together around an alcohol Bill and achieve the necessary compromises to get a majority in the House. I have seen him manage scandals with compassion, professionalism and unbelievable energy and dedication. I have seen the victims of those scandals praise him for it and wish him well in his future political career. I have seen him build cross-party support and consensus around the kind of future health reform we need in the context of Sláintecare. I have seen an extraordinary commitment from him as a politician and Minister for Health to making that happen. When I see political leaders like Deputy Howlin refer to Deputy Harris a week ago on radio as a capable and competent Minister only to come to the House today to vote against him, it reminds me of what party politics is sometimes about.

I refer secondly to the sponsors of the motion who are behaving true to form. Sinn Féin is about division. It is about targeting individuals for political ends, whether it involves the HSE, PSNI, gardaí, Ministers or others in the House.

It is about holding people to account.

This is its sixth no-confidence motion in less than three years. Instead of trying to work within the political system to make policy changes and progress and get real things done, Sinn Féin releases its keyboard warriors, placards and billboards with Ministers' faces on them. Let us look at what Sinn Féin is actually doing in a way that is consistent with its accusations. It accuses Fianna Fáil of political cowardice and an abdication of responsibility and talks about acting in the national interest. However, Sinn Féin is democratically elected to three parliaments.

Its members refuse to take their seats in one, supposedly in the interests of Sinn Féin, at a time when that parliament is making crucial decisions that will impact on this island. They pulled down another one in Northern Ireland and justified their reasons for doing so. They are doing little to rebuild it in the interests of the people.


Today they are trying to pull down this Parliament, too, at a time when it is doing crucial work in the national interest, both in the area of healthcare reform and 36 days before Brexit. There is only one party in this House that has no confidence and there is a good reason nobody wants to work with it in government.

Deputy Stephen S. Donnelly

Tucked away on the outskirts of Galway city is the Galway Autism Partnership, an amazing organisation that is providing badly needed support for children and parents. In Shankill St. Joseph's Nursing Home has revolutionised dementia care in Ireland. The National Maternity Hospital in Dublin city now has a foetal MRI scanner which greatly increases the ability to detect foetal and fatal foetal abnormalities and there are paediatric radiologists who can use it. Carers, volunteers and healthcare professionals throughout the country work hard and every day succeed in making the healthcare system better and more effective and compassionate, but they do this not because of the Government but, largely, despite it.

The Galway Autism Partnership has exhausted its fundraising. It needs €70,000 per year from the Government to survive or it will close in six weeks. So far, it has received no funding. St. Joseph's Nursing Home in Shankill receives far less from the HSE than the HSE pays its own nursing homes and its model of care which is revolutionary is now at risk. In the National Maternity Hospital the foetal MRI scanner lies unused because funding has not been released to use it.

In the past four years the Government's spending on healthcare has increased by more than €4 billion. It is one of the highest figures in Europe, yet somehow people in Ireland wait longer to see doctors and receive treatment than anywhere else in Europe. We have the second lowest number of hospital beds per capita and the lowest level of consultants in Europe. Mental health services are in crisis and general practice has been hollowed out. Some children with special needs are waiting three and a half years for an intervention. Children with scoliosis cannot undergo assessments for a wheelchair, while 10,000 children are waiting for more than 18 months for a hospital appointment. Why is this happening? It is because the Government has lost control of healthcare.

Fianna Fáil is keeping it in office.

Deputy Stephen S. Donnelly

First, the Government was going to scrap the HSE, but it did not. It was going to fund healthcare via universal health insurance, but it did not. It scrapped the board of the HSE, but last year, because of CervicalCheck, it decided to put it back in place. It has now appointed it. There are ten people on it, but it turns out that not one person on it has a medical background.

Matters have been getting even worse this year. January marked a new high in the number of patients waiting for hospital appointments. The figure is now 523,000. The Taoiseach, when he was Minister for Health, set a target that nobody would have to wait for more than 18 months. Today, 100,000 have been waiting for 18 months. Hundreds of GPs took to the streets outside Leinster House and the ambulance drivers took industrial action. The nurses and midwives also took industrial action, as did the psychiatric nurses.

The Deputy is working up to a motion of no confidence.

Deputy Stephen S. Donnelly

Waiting times for CervicalCheck have jumped from two weeks to six months. Some 78,000 women are now waiting for results. The Government announced that the HPV test would be in place by last September and then by January, but last week the HSE told us that there was no longer a date. The Minister was asked repeatedly to stop the free test. That is documented. Last week he said in the House that at no point was he ever given advice not to proceed with the test. The day before the test announcement was made the clinical director of CervicalCheck was on the national airwaves advising against out-of-cycle repeat smear tests, except in exceptional circumstances. Last Sunday Susan Mitchell wrote in the Sunday Business Post that CervicalCheck had advised against a free smear test and had done so before the Government made the offer. If that is true, we need to know if the Minister has misled the Dáil for a second time.

Then there is the issue of the national children's hospital. In 2016 it was due to cost €650 million in total. It is now €1.7 billion and counting. The two most expensive hospitals ever built in the world are in Adelaide and Stockholm. The cost per bed at these two hospitals came in at €1.6 million and €1.8 million. At current costs, before they potentially increase, the cost per bed in the national children's hospital will be approximately €3.6 million, or twice as much as in the two most expensive hospitals ever built. When I pointed this out, the Government responded that they were not children's hospitals and that I had to look at children's hospitals. Let us do that. Four years ago the Alder Hey Children's Hospital was completed in Liverpool. It has 309 beds and the cost came in at €270 million. That gives a cost per bed of approximately €900,000. The public money of the taxpayers of Ireland is being used to provide beds in a children's hospital that will cost four times more per bed than the NHS was able to deliver for children in Liverpool.

The Government's response has been extraordinary. First, it kept the information to itself. While the development board hired a public relations firm to gauge the public's reaction to the bad news, this House was kept in the dark. When the facts began to emerge, the first line of defence was that it was due to inflation. It was unfortunate, but inflation is what it was and what could one do? In fairness to the Minister, last week in the House he accepted that inflation was not driving the increase. The Government has an extraordinary line to the effect that it is not really a cost overrun but that it underestimated the cost at the start. Underestimating the cost is regrettable, but it is obviously less grievous than just letting costs spiral completely out of control. Defying all credibility, the Government's current position is that, at €1.4 billion, plus another €300 million to open it, it still represents a reasonable cost to the State.

Fianna Fáil does not have confidence in the Government when it comes to healthcare. We do not have confidence now and did not have last year when waiting lists and trolley counts broke all records, but we will not be voting confidence in the Minister. Reasonable people might ask why Fianna Fáil would abstain in the vote. It is because if it were to do otherwise, it would trigger a general election.


Deputy Stephen S. Donnelly

That means that there would be no Parliament for three to four months, no parliamentary oversight of CervicalCheck in having the backlog eliminated and losing any chance of getting down the cost of the children's hospital. While we all vie for votes, BAM, rightly, would continue to build and the window of opportunity will be lost.

It already went out the window.

Deputy Stephen S. Donnelly

It means that there would be no Irish Parliament in the closing weeks of Brexit. Some 45,000 jobs are at risk in every town, village and county. The Good Friday Agreement is at risk, as are cross-Border initiatives in healthcare. The agrifood sector is also at risk. It is a risk in having no hard border around the Six Counties. Most people get this.

Most people in Fianna Fáil but not outside.

Deputy Stephen S. Donnelly

Most people, while utterly frustrated by the Government's performance in healthcare, agree that a general election in the closing days of Brexit would be madness. Of course, that is not the case with Sinn Féin, but we should not be surprised. It has been and remains the best friend the Brexiteers have ever had. Due to it, the only political voice from Northern Ireland heard at Westminster is that of the DUP and we all know how it feels about a hard border and Brexit. Due to Sinn Féin, the people of Northern Ireland have no directly elected political voice in Belfast.

They definitely do not have a Fianna Fáil voice because that party will not stand for election.

Deputy Stephen S. Donnelly

Now, weeks before the Brexit deadline, Sinn Féin would like to complete the hat trick and collapse the Dáil also, taking Ireland away from the EU table while aspects of its future are being negotiated. This is Sinn Féin's choice, on which it should be judged.

Fianna Fáil's choice is to focus on eliminating the CervicalCheck backlogs, to get answers on the national children's hospital-----

How is that going for you?

Deputy Stephen S. Donnelly

-----and to keep the focus on reducing costs.

How did Fianna Fáil's confidence-and-supply negotiations go?

Deputy Stephen S. Donnelly

Fianna Fáil's choice is to provide the stability Ireland needs right now to protect the country from the threats of Brexit. Fianna Fáil's choice is to present a credible alternative to the current Government and credible solutions to the challenges this country faces in healthcare.

I welcome the opportunity to speak on this motion. A little contrition in the Minister's tweets would not go astray because it is a simple fact that the health system is in crisis. Every day of the week we see waiting lists, hospital trolleys, capital overspends and budgets running awry. At the same time the Government seems to have no concept that there are huge difficulties out there, even though they are consistently highlighted by Opposition parties and Deputies on all sides of the House. The Minister has a problem when it comes to his handling of the health services. The cancer scandals, the children's hospital, the waiting lists - everything is consistently poorly handled. The Minister's management skills and those of his Government and the Department are sadly lacking, and that is a fact. Deputy Donnelly asked whether there is confidence in the Minister. The House has consistently raised the difficulties in the health services, so every day of the week many people show no confidence in him and his handling of the health services. A little contrition and more action are what is required from his good self, and he should stay off the Twitter machine.

As for the other issue that has been raised by the sponsors of this motion, Sinn Féin Deputies, there is a difference between being a party of opposition-----

Do not lecture us.

-----and a party of opportunism. Sinn Féin is a party of opportunism.

Fianna Fáil Deputies are the opportunists.


Listening to this debate, there was very little concern about the real issues.

Is this the Deputy's European election speech?

All Sinn Féin Deputies consistently spoke about was Fianna Fáil.

Is the Deputy going for the European elections?

I thank them very much for consistently mentioning us. Of course, the real reason they are highlighting these issues has nothing to do with the many patients waiting for inordinate periods because if they were that concerned, they would be in Stormont advocating for patients on waiting lists in Northern Ireland as well.


Sinn Féin is just a party of opportunism.

Brexit is five weeks away, and this State could potentially face a catastrophic event-----

-----and all Sinn Féin is interested in is having political chaos across the island because it thrives on it and has consistently promoted that anarchist-type view. Let me be very clear: when Sinn Féin Deputies advocate for their constituents and the concerns of their constituents-----

Do we not do so?

-----they should also accept that they have failed to advocate for the people in Northern Ireland when they stood for an Assembly election and then pulled down the Assembly. They are a shameful bunch of hypocrites.


The Government's and the Minister's failings in health are many and well documented. Not voting for this motion does not for one moment mean an endorsement of the Government's record on health. Its handling of the children's hospital and CervicalCheck issues has been completely inadequate. Similarly, the recent nurses' strike should not have been allowed to develop as it did. However, thrusting the country into a general election on the eve of Brexit would be an act of national sabotage. This is a cynical, empty and irresponsible motion from Sinn Féin. Thirty-seven days out from Brexit and the best friends of the Brexiteers, Sinn Féin, are confused, judging from the motion.

The Fianna Fáil Deputies are all reading from the same script.

Is this a motion of no confidence in the Minister for Health or, judging by the opening statements, a motion of no confidence in Fianna Fáil?

This is typical Sinn Féin politics, this from the same party that has ensured that the only Northern Ireland voice in Westminster is that of the DUP; this from a party that will abstain from its seats in Westminster yet still take the Queen's shilling; this from the party that collapsed the Assembly in Belfast, leaving Northern Ireland at the mercy of Westminster.

Deputy Stephen S. Donnelly

Sinn Féin takes the expenses.

Sinn Féin would have us force the country into a general election. The tabling of this motion is as clear an example as any that Sinn Féin as a party does not understand what the national interest is-----

We are a party that stands for elections nationally.

-----and is utterly unfit for Government. The hallmark of Sinn Féin is the politics of turmoil and chaos, and so it continues.

The people of Waterford say different.

This motion is a new act of hypocrisy on the part of Sinn Féin. Earlier I heard Deputy Pearse Doherty eventually admit that he and Sinn Féin do not want an election and do not want to bring down this Government, yet in tabling this motion they expect Fianna Fáil to break the terms of an agreement and not cause an election. Thankfully, for the country's sake and our sake, Sinn Féin cannot and will not have it both ways.

Fianna Fáil's grubby little deal is between it and-----

Excuse me, mister.

Notwithstanding ongoing and continued questioning-----

Yes. Some Sinn Féin Deputies have that title, unfortunately.

That is "Deputy" to you.


May we have order, please?

Is this Deputy Cowen's speech for the European elections now?

Deputy Cullinane should stick to Waterford and see how he gets on.

Notwithstanding ongoing and continued questioning of the Government on the children's hospital, and notwithstanding the Government's meandering responses to date, its secrecy, its hiding behind FOI legislation and its efforts to manage the news rather than the Department of Health, our concern and our commitment is to get to many of the answers not yet given in order to ensure overruns stop and taxpayers' money is not squandered further. Parallel to this, our overriding ambition is for this country and for the island of Ireland. We will not participate in or support acts of sabotage or treason at this crucial time in our history.

You brought the IMF here. What are you on about?


Order, please.

You do not like it, do you?

No, we definitely did not.

We all participated in, signed up to and welcomed the overwhelming support in this country for the Good Friday Agreement. At a time when that agreement could provide for a Government that could lead and win the rewards associated with a successful all-Ireland economy and all-Ireland integration, ensuring an economic future and, most of all, security and peace in this country, what did Sinn Féin do?

What has it done every time when it has come to playing a match fair and square and for those whom it represents?

We did not bankrupt the country.

It walked off the pitch again.

At least we were on the pitch in the first place.

If we depended on his backup, we would be a long time waiting for Deputy Brady to be on the pitch.


Sinn Féin will not be love-bombing us, that is for sure.

The Deputy can be sure of that.

I was surprised by the Minister's bring-it-on statement earlier. His list of achievements to date is one thing, but there would be many items on a list of commitments that have yet to be honoured. Not long ago the Minister said he was no messenger boy; the next week he was apologising for not providing information to me in the Dáil. It is the Dáil that ratified the Taoiseach's nomination of the Minister to his office so he should not lose sight of that responsibility. We implore the Minister to pull up his socks and start managing the Department effectively rather than obsessing with managing the news associated with that Department.

Brexit or no Brexit, regardless of how it turns out, this debate quite clearly puts the Government on notice - notice to quit. It has a litany of failures, health being just one. This motion of no confidence in the Minister should be a notice of no confidence in the Government itself. Each and every one of the Departments over which it has presided has at one stage or another seen unfulfilled promises, overspends and poor management. Behind the Minister and the Department of Health are all the officials who were engaged in this, and they have turned around to the Oireachtas committees and told us they will not appear before us. The Government allows this to happen. I suppose, by extension, we allow it to happen. There are those of us in this party, on this side of the House, and indeed within the party ranks and among the public, who want us to pull the plug.

I ask the Government, in the face of Brexit, to wind itself down in an orderly way. It is an utter failure in what it has done and I would support a vote of no confidence in the Government itself because the Minister cannot be left on his own. The rest of the Government also bought into the matter and were present when the Minister told the story about the overspend and so on. What is forgotten in this debate is not the national sabotage that has been described but rather the sabotage of people's rights, namely, to a home or not to have one's house repossessed by a vulture fund. Although we may not like Ben Gilroy, his and others' rights have been ignored and he is in the lock-up. The Government has ignored many rights.

Fine Gael claims to be the party of accountability but when voting for the recent Comptroller and Auditor General (Amendment) Bill 2017, which was put forward by my party, Fine Gael refused to support it. I no longer know why we support the Government or why we sit on our hands and allow it to function. Both the public and the majority of the House have had enough of the Government and, therefore, it should go.

Debate adjourned.