Financial Resolution No. 9: General (Resumed)

Debate resumed on the following Financial Resolution:
THAT it is expedient to amend the law relating to inland revenue (including value-added tax and excise) and to make further provision in connection with finance.
-(Minister for Housing, Planning and Local Government)

I am sharing time with Deputy Haughey.

Is that agreed? Agreed.

I welcome the opportunity to speak on the budget that was announced here last week. People throughout the country are beginning to ask questions. They fully understand the budget was framed on the basis of a no-deal Brexit and that it was correct to take a prudent line in the event that it might happen. However, in the event that we do have a deal this week, next week or whenever in the immediate future, people are now asking where the €1.2 billion that was being set aside for a no-deal Brexit will be spent if we do not have a no-deal Brexit given that there are many people with needs. I accept that some of the money was to be borrowed. Since the Minister made his speech last week on the basis of all this money being provided in the event of a no-deal Brexit, a homeless person has been murdered on the streets of Cork. It demonstrates the widespread problem in respect of homelessness and lack of facilities. I could continue in that vein. Given that the Government has money available in the event of a no-deal arrangement, if the money is not all required for that purpose I hope this Fine Gael Government will decide to allocate some of the money to deal with urgent issues such as once and for all dealing with the housing issue.

The Government has not addressed housing. The reason it has not is because it is not the Fine Gael way to worry about the people on the housing list. We had the most troubling statement in the Dáil on Leaders' Questions on Tuesday when Deputy Micheál Martin raised the case of the homeless man being murdered in Cork. The Taoiseach blamed the man himself. He said he had been offered an apartment. That means the Taoiseach does not understand the complexities of what is involved with some people who are homeless. He thinks it is a case of throwing someone into an apartment and that is it. I do not speak of the person involved, but it shows the Taoiseach did not understand the issue at all, not to mind having empathy or an interest in solving it. That is the reason we have the problem. In saying the man was offered an apartment, the Taoiseach was essentially blaming the man for being homeless. What the Taoiseach said about homeless people and the attitude he showed in this Chamber was outrageous. If he had any understanding he would know that some people are homeless for reasons of mental health, disability and addiction. It is not just a case of having a square room to put a person into. For the Taoiseach to suggest that the man was offered an apartment, and for some reason he did not take it and it was given to someone else, shows a total lack of understanding and empathy for people who are homeless.

I do not intend any offence personally to the Taoiseach but that is a bit of the Fine Gael DNA. I know Fine Gael people who say if people are homeless or unemployed it is their own fault. They ask why those people do not get up and do it like the rest of us. Life is not as simple as that. It is more complex.

I raise the issue because it happened since the Budget Statement by the Minister for Finance last week and if all the money is not required for a no-deal Brexit we would want to ensure some reallocation of the funding that would be set aside. Not all of the money to deal with Brexit and other such issues was to be borrowed. I highlight the issue because the Minister made a big play of a no-deal Brexit in his speech. If people analyse what the Taoiseach said, they would be deeply upset to think that was his attitude on the floor of the Dáil Chamber to a homeless person who was murdered.

There were a few good items in the budget thanks to Fianna Fáil. We fought long and hard and I am very pleased that we secured 1 million extra home help hours. To underline why that is important I will explain what happened throughout the country this summer. No support was given when the directly-employed HSE home support staff who were providing home help took their two weeks holidays during the summer, which they are entitled to do. They will also take a break at Christmas. Elderly people living alone and families were left to fend for themselves during that period. When the HSE contracts a home-help agency, it is contracted to provide 52 weeks cover, which includes the holiday period. We had a crazy situation whereby the HSE was not replacing its own staff. People who thought they were fortunate having a direct employee of the HSE coming in to provide home help got a sharp shock this summer when they got no cover. They were abandoned and left high and dry for the two weeks. That happened, and I am afraid the HSE will try it again at Christmas and then it will establish a pattern. They will say they got away with it during the summer and they will try it again.

It is the thin end of the wedge. We need more home help hours.

I am also pleased that funding has been provided for 1,000 additional therapists, nurses and healthcare and professional staff and that €2.5 million has been provided for the Fianna Fáil initiative, the National Treatment Purchase Fund, which reduces lengthy waiting times for cataract, hip and a variety of other surgeries. In the last three budgets we had to drag the Government kicking and screaming into providing that extra money. It resisted giving it on several occasions because it does not believe in the initiative, but we do. It is working and reducing some of the waiting lists.

In terms of education, provision is made for 150 new teachers and €1.9 billion for special education, which will allow for 400 additional teaching staff for children with special educational needs and 1,000 additional special needs assistants, SNAs. We are also very pleased with the commitment we have secured for the recruitment of 700 new gardaí.

The main issue in this budget is the carbon tax and there has been much debate on it. For the first time, we are seeing where the increase of €90 million in carbon tax is to be utilised. Last year, €430 million was raised in carbon tax. I would like to know where the more than €500 million raised in carbon tax in the coming year will be spent. There is no transparency across government in regard to how it is spent. The Government raises carbon taxes on diesel, petrol, marked gas oil, natural gas extraction and kerosene, solid fuels, coal and peat, liquid petroleum gas and fuel oil. A breakdown of these categories is set out in the recently published ESRI document. The Central Statistics Office, CSO, produced a report in the summer on fossil fuel and similar subsidies, in which it criticises the use to which some of the carbon tax collected has been put and states that it is detrimental to the environment to compensate people to continue to burn fuels that we should be encouraging people to move away from. In regard to the fuel allowance, the objective of the Government should be the retrofit of houses such that they will need less heat and become more environmentally friendly. This could be done through the installation of solar panels, additional insulation, double or triple glazing and so on. We will be able to reduce the amount of heating required in houses if they are more energy efficient in the first instance. This is the route we should be taking on this issue.

On the carbon tax, I have raised this issue wearing my hat as Chairman of the Committee of Public Accounts. The Comptroller and Auditor General report published a couple of weeks ago states that, given the increasing level of related income and expenditure, it would be timely for relevant Departments to consider the potential to provide additional information and disclosures in respect of climate change initiatives in the statutory accounts they produce in respect of carbon tax. The report includes a chart which shows receipts of well over €3 billion in carbon tax since it was introduced in 2010. It now stands at €500 million per annum yet there has been no transparency in regard to where it is spent. I am arranging for scrutiny by the Committee of Public Accounts of the Economic and Social Research Institute, ESRI, and the Central Statistics Office, CSO, in regard to where taxes raised are spent, which is the core function of the committee. We want to ensure there is public transparency in this regard as otherwise people will see it as a tax and they will not know where it is being spent. We want to know where the €3 billion to €4 billion collected in the last couple of years was spent and transparency year-on-year into the future in regard to future receipts, which the Comptroller and Auditor General has called for in his report. We will also engage with the Departments on what initiatives they have taken in terms of CO2 emissions, utilising the €3 billion to €4 billion already collected and spent and the €500 million or more that will be collected next year.

My final comment relates to public private partnerships under the heading Exchequer-funded financial commitments under public private partnerships and concession projects referenced in the charts contained in the Minister's speech. There are 29 projects, worth €10 billion, being undertaken by public private partnerships, some of which run for 50 years with others running for 25 years. Again, there is a lack of transparency in this area. There is no mechanism for the Oireachtas to get behind those contracts because they are deemed commercially sensitive. This House will have to address that issue.

Fianna Fáil has facilitated this Government given the unprecedented threat of Brexit, deal or no-deal. As a party, Fianna Fáil has again put the country first and provided the political stability that it needs at this time. This is in sharp contrast to the political situation in some other EU countries, including the United Kingdom. There are many reasons this Government should be put out of office, including the ongoing crises in health and housing, but not just yet. I have no doubt the electorate will pass judgment on the Government's performance in the not too distant future.

I am disappointed that State pensioners did not get their usual €5 increase in this budget and that there was no increase in the rates to be paid to all social welfare recipients. Many State pensioners are unhappy about this. In its post-budget analysis, ALONE described this as hugely frustrating. The increasing cost of living is a big issue. Many older people face financial hardship, which is often hidden. I suspect the Government will hear more about this in the coming months.

There are a number of threats to the economy at this time and there are predictions of a decline in economic growth. These threats include Brexit and the global trade wars. In addition, Germany is on the brink of recession. We have a high dependence on corporation tax receipts and it seems there are more difficult times ahead for everyone.

Fianna Fáil had some input into this budget. Its emphasis on improved public services rather than tax cuts has been taken on board. We are pleased that some progress has been made in a few important areas. An additional 700 gardaí will be recruited, thus meeting the demand for a more visible Garda presence in our communities; an additional €100 million has been provided for the National Treatment Purchase Fund, which should help to reduce hospital waiting lists; the help-to-buy scheme has been extended; and funding for respite care and residential placements has been increased.

I would like to address some of the issues in the budget of particular concern to my constituents. It is clear that obligations arising from the Disability Act 2005 in respect of children with disabilities are not being met. There are lengthy waiting lists in north Dublin for primary care services and therapies provided under the assessment of need and early intervention team provisions. This is unacceptable and causes untold stress for these children and their parents. It is not right that there are many children with autism or special needs without appropriate school places in either a special school or special class. In some cases, reduced timetables are imposed. I have previously called for HSE staffing levels in the appropriate therapy disciplines to be increased to tackle the waiting lists in Dublin north city and county. I have also outlined the need for a five year projection of special needs education in each school catchment area to be undertaken without delay to ensure that the necessary school places are provided in a timely manner. The recruitment of additional therapists to allow for more assessments for children with special needs and for therapy interventions is provided for in this budget. However, we require more detail, including how many therapists will be recruited in 2020. It is obvious that the HSE has an unofficial moratorium in place on the recruitment of new therapists. I welcome the 400 additional teaching posts to support those with special educational needs. However, we need to be assured that all these measures are not just to meet increasing demographics and that they will result in a real improvement in these public services.

The provision of 1 million additional home help hours is also welcome but it is not enough. The lack of home care packages and the limited number of hours in these packages is a real problem. In my constituency, patients in acute hospitals such as Beaumont and the Mater very often cannot be discharged owing to a failure to sanction home care packages. This causes a great deal of stress for patients and their families.

It is clear that this service is not able to keep up with the demand and much more needs to be done in this area.

I welcome the package on climate change, including carbon taxes. I fully support the measures in the report of the Oireachtas Joint Committee on Climate Action. Revenues from carbon taxes must be ring-fenced for specific environmental measures, in particular vulnerable people at risk of fuel poverty must be protected. I note that the recent Economic and Social Research Institute, ESRI, analysis of the budget suggests that lower-income groups will be disproportionately hit by the rise in carbon tax. While the fuel allowance was increased, fewer than half of the poorest households get this fuel allowance. More needs to be done with these ring-fenced revenues to protect those at risk of fuel poverty.

From a constituency point of view, I am concerned at the lack of capacity on the DART and the need for new carriages. The budget provisions for the Department of Transport, Tourism and Sport are wholly inadequate. There is a significant demand for increased capacity on the DART. Commuters from my constituency trying to get into the city during the morning peak in particular are crowded into the carriages. Much more investment is needed in that area.

Where is the long-promised emergency department and cystic fibrosis unit at Beaumont Hospital? These projects are in the programme for Government, but it is taking a long time for them to move through the system stage by stage. The Government has been in office for four years and these projects are not being given the priority they need. Progress is very slow and it seems that they will not be constructed any time soon.

There is a real problem with the Department of Health. Obviously, there will be another Supplementary Estimate for that Department. It is clear that our health services are in crisis. Many announcements have been made in the budget and outside the budget, but there is very little delivery in respect of these announcements. The financing of many of the projects announced seems to be loaded into future years. This is not just in the Department of Health, but across many Departments. The budget for the Department of Health is €17.4 billion. We have a real issue with changing demographics. The HSE seems to be in crisis and some serious problems need to be addressed.

Over the summer, constituents told me they had been approved for the fair deal nursing home scheme, but the funding was not available. I believe funding is being allocated on a staggered basis, which is not good enough. This is a major issue and it causes considerable distress for older people and their families. It is a big decision for a family to put a loved one in a nursing home. Having gone through the whole process and having been accepted for the fair deal nursing home support scheme, the money is not available or there are significant delays in paying it out. That needs to be looked at carefully.

The ESRI assessment of the budget concluded that most households are facing a real tax increase due to the decision to freeze tax bands and tax credits. That will not be lost on the public in due course. If the Government does not adjust the tax bands and tax credits, people will end up paying more tax. The ERSI report was very negative. It basically described the budget as regressive.

Those are my thoughts on the budget. While progress was made in some areas, as the saying goes, there is a lot more that needs to be done. I will conclude by reiterating one of my initial points. State pensioners have come to expect the traditional €5 increase and they are very cross that they did not get it this year. They are the silent majority and I think we will hear more about that in the months to come.

I have listened to quite a bit of the debate so far on budget 2020. I also spent three hours in the other House listening to the debate there. Some of the conversation about it is very unfair. In the year that is in it, with Brexit looming large over us, I would describe it as an as-you-are budget. Many more people are talking about what is not in the budget than are talking about what is in it.

Average earners are not getting not tax reductions as they did in previous budgets. As Deputies Haughey and Fleming mentioned, social welfare recipients will not get a €5 increase. However, it is important to put the numbers front and centre for people to understand them. A €5 increase for people on social protection payments across the board would cost €360 million, which was more than half of the additional expenditure available for 2020. I disagree with Deputy Haughey's suggestion that we should have given half of the entire pot of what was available to just one group. I would like to give that fiver to pensioners and others in receipt of social protection payments, but this year is not the year to do so.

I presume the Deputy knows the social protection budget for 2020 is €21.095 billion. That is more than one third of all expenditure. We will spend €61.9 billion and the social protection pot accounts for €21 billion of it. It is a very large amount of money. It is wealth redistribution that we have copper-fastened since we came into government after the disaster of the 2010 budget and the 2010 deficit which was 32% of GDP. The Deputy will remember that because he was here when it happened. It was a catastrophe. Those were the circumstances in which we had to start. I also remind the Deputy that in 2011, at the very bottom of the recession, we brought in €11 billion and in that same year we gave out over €20 billion in social protection payments. I entirely disagree with the assertion that we are not doing right by pensioners.

I entirely disagree with Deputy Fleming, who is Chairman of the Committee of Public Accounts, about Fine Gael DNA, because the numbers do not support what he is saying. It is a nice easy cheap line from Deputy Fleming about Fine Gael's DNA, but it is wrong. Page 85 of the budget book, the expenditure report, states that the State will spend €8.5 billion on pensions. It is the largest single line item of expenditure. It is nearly as much as the education budget and 2.5 times the justice budget. The Deputy needs to look at the facts, which refute everything he said about pensions and what Fine Gael is doing for pensioners.

Deputy Fleming also highlighted the pieces that Fianna Fáil did. I acknowledge the support of Fianna Fáil. Fianna Fáil has been good and has done the right thing by the country through the confidence and supply agreement. I dispute the statements of the Sinn Féin Members who engage in easy, cheap politics by criticising Fianna Fáil for supporting the Fine Gael-led Government to try to maintain political stability. I have always highlighted and acknowledged that.

I want to call out Deputy Fleming when he spoke about the good stuff Fianna Fáil put in the budget.

There certainly was but everything else in the budget is not wrong. We have put in place a lot of very good initiatives in this and previous budgets. I want to call this out. I absolutely support the 1 million extra home help hours. It is a very good thing, as is the National Treatment Purchase Fund, NTPF. Many people would say the NTPF is not money well spent but I am sure the people getting operations and treatments do not say this. They have benefitted from it through the support of Fianna Fáil by abstaining on the budget. It is very easy for Sinn Féin to hurl from the ditch. There is nothing easier.

I want to touch upon some of Sinn Féin's narrative. In particular, Deputy Cullinane has said that Fine Gael is the party of business and that there is a golden circle. Fine Gael is intent upon creating jobs. The only way to create jobs is with business. The work we have done in recent years shows we have been successful in this aspect. A total of 2.3 million people are at work in this country, which is the highest number of people at work ever. This leads to improved income taxes. The quantum take for income tax has almost doubled from the low point of 2011. This means we have more money to do the things we want to do to put people into circumstances whereby they are not claiming social protection payments and ensure we can add the €5 at some point in the future for people on social protection payments, whether old age pensions or working age income supports. This is absolutely what is required. Sinn Féin has a go at programmes such as the special assignee relief programme, SARP. SARP is a very good programme for people from other jurisdictions who can come here and be charged lower rates of income tax because they have specific types of expertise and skills that potentially we do not have here. Most of these people come here for a short period. They work here, pass on those skillsets and bring business lines to the country that bring other employment opportunities for other people. There is nothing easier for Sinn Féin than to have a go in the manner it does. What was not easy was the creation of jobs. The success of this and the previous Government in creating jobs and getting people back to work has led to going from a high unemployment rate of almost 16% to the current low rate of 5.3%. This is pretty close to full employment but no credit is coming from the other side. It just throws negative mud hoping it sticks and that it causes damage. This is the cheap political banter we see in other jurisdictions and it will not be successful.

I want to touch on the social protection budget because there is an attempt to create the impression that we do not support people. Working age income supports amount to €3.2 billion and on top of this is another €650 million for employment supports. Illness, disability and carers receive almost €4.7 billion. Carers are very important people who do a superb job on behalf of the State. A figure that sometimes gets overlooked is children's allowance payments, which amount to almost €2.7 billion. This is a huge quantity of money that is almost equivalent to the budget for the Department of Justice and Equality. The perception that there is no income transfer in the jurisdiction is absolutely, completely and totally wrong.

The current and capital health budgets amount to more than €18 billion. I stand to be corrected but this is the largest amount ever. We have an issue with our health sector. Everything in the health sector is not wrong and it is wrong of politicians to state everything is wrong. This is not the case. Many people get a very good service from the health sector but some people do not. We know there are pinch points and areas where we are challenged with regard to not just money. We have money for staff but we struggle to hire staff and employ them at the particular wage rates we have agreed. Overall, we have a good health sector but there are difficulties in some areas. The biggest challenge I see is that in the areas where there are difficulties part of the problem is the body politic. Nobody gives an inch to reform the sector and put it on a better standing and put it where it should be. We see the pathway for Sláintecare but we will see how beneficial it will be when it comes to reforming and restructuring services to larger centres throughout the country. We are moving from smaller centres to areas with better outcomes and superior outcomes. This is something we have to do.

The €11.2 billion current and capital budget for education is the largest amount ever. It is a huge amount but we must ensure we have the right people in the right place at the right time with the right skillsets to fill the positions required for indigenous companies and companies from outside of the State. We need staff to fill those positions. Our competitors throughout the world state the main reason companies come here is because of our corporate tax rate. This is not right. I meet executives who are established here. The single biggest reason they come here is staff. It is because of our standard of staff, the capability of the staff and their adaptability and willingness to be flexible in the workplace. We cannot be complacent about this. We cannot accept that if we stand still we will go ahead because we will not. We must make sure we have the right staff with the right education and skillsets for the future. There are new technologies coming and we must ensure we fill those positions, which we are doing in the main.

An extra €81 million has been provided for the justice budget on top of what was spent in previous years for an extra 700 trainee gardaí. This takes us to almost 14,500 gardaí, which is the number we want. I support the Commissioner's new strategy, which is to get gardaí out of stations and policing. This is something that is very important. I am delighted to see the success of Operation Coatee, through which the Garda National Economic Crime Bureau is chasing criminal fraud in the insurance sector. The success of the operation with this funding is very important.

I want to touch on another aspect of my brief, which is insurance. Last summer, the Judicial Council Act was passed. Many people thought we would not get it through the Houses but with the support of both Houses, for which I am very grateful, we did. The big work will happen next, which is the establishment of the personal injury committee within the Judicial Council. I hope the seven judges will be in place very soon, by which I mean days and not weeks. The seven judges can then get on with the work of reducing the guideline amounts. It is very important to show business that the era of awarding a lot of money for damage that has a very small impact on somebody is ending. The insurance companies have given commitments to the finance committee in public, which is good, that if the awards reduce so will premia. They have given me the same commitments in private. I have been to London to meet the underwriters, who have left the market in particular sectors. If the awards reduce so will the premia. This is something that is crucial for business.

With regard to Brexit, the figures we are deploying to put in place if it is required are huge. We do not know whether the finance will be required, whether or not there will be a deal or whether there will be a crash out with a deal done afterwards. We do not know but we will find out very soon. It will be concluded in a matter of weeks.

I am sure there will be a few twists and turns arising from whatever happens today, what happens at the summit tomorrow and on Friday and, potentially, what happens in the next week or ten days. We will see. We have to make sure that structures will be in place, if required. We must have the firepower to deal with what could potentially be a very bad outcome. A sum of €1.2 billion, in addition to the €2.9 billion that has been committed since budget day, will be borrowed in 2020, if required, to deal with a bad outcome. The details of this are already on the record of the House. We will also borrow additional money beyond that, if it is required. We have not put a ceiling on that figure because we do not know the extent of the damage or negative consequences that might flow from a very bad Brexit. We could also potentially make use of the rainy day fund. If borrowing costs increase too greatly, we can use that additional €1.5 billion.

We have to prepare for the worst-case scenario. It is my personal view that a deal will be done. It would be a complete failure of politics if a deal was not done. I do not know when it will be done. Will it be done before or after the UK crashes out? That is a difficult question to answer. It is the moveable part that none of us has our head around. Circumstances can sometimes flow, change and evolve over a period of negotiation. We really do not know.

To return to the budget, there will not be an increase in the threshold at which people pay the higher rate of income tax. Our jurisdiction is highly unusual with regard to income tax. In very few jurisdictions do people who earn the average wage pay income tax at the higher rate. The Taoiseach has been very clear on his view in this regard. He wants people to be able to earn more money while paying less tax. He wants people to be better off working than not working. He has been criticised as though he is some form of crazy right-wing politician for wanting this. His goal is to try to allow the average earner to take home more of his or her salary. There is nothing crazy or right-wing about that policy. In fact, the left should be out the door supporting that. When we came into office, the threshold was closer to €30,000; when the next election is held it will be €35,400. That figure must grow closer to €40,000. In the UK, people can earn up to £50,000 while paying tax at the lower rate rather than the higher. There is an enormous difference between the UK and Ireland.

With regard to the increase in stamp duty, the stamp duty figures are very buoyant. Last year, we increased this duty to 6%, which is closer to the rate at which it had been levied. We are now increasing it by a further 1.5% to 7.5%. The rate used to be 9%. I remind Members that was the standard rate of stamp duty on commercial property.

There is also a change with regard to Irish real estate funds, IREFs, and real estate investment trusts, REITs. We have had a pretty in-depth look at this area. There are three or four REITs in the country. We are satisfied that they are operating quite well and in the manner in which we expect them to operate. There are a few issues to be dealt with. The IREFs are operating less well. Revenue has highlighted a number of matters to us. There are approximately 148 IREFs in the country and a number may be involved in tax avoidance. We are dealing with those issues in the finance Bill. They have to be dealt with pretty soon.

There are a number of other areas on which I want to touch. These include climate change and the carbon tax. Deputy Fleming asked about the sum of more than €500 million that has been raised from the carbon tax introduced in budget 2010. This tax was brought in at €20 a tonne. It was not ring-fenced. It was a measure to raise tax revenue and the funds go into the general pot, which pays the €8.6 billion for the old age pension in respect of which Deputy Haughey was critical of the Government. The extra €6 per tonne introduced in budget 2020 will raise approximately €90 million, which will be ring-fenced for green actions and lessening the impact of the tax on those in fuel poverty. We have a method to do this through the social protection budget.

I call on Deputy Donnelly. I understand he is sharing time with his colleague.

A 15 year old girl with scoliosis has had her operation cancelled repeatedly. As she has waited, her spine has curved to almost 90°. A mother in Wicklow has waited years for speech and language therapy for her son. Three weeks ago, she got a letter saying it will be another two years before he is seen. Men and women who are well enough to be at work are instead lying in hospital beds because this is the only way in which they can access diagnostic services such as MRI scans. They are told that if they go home they could have to wait six months, 12 months or two years. A young man paralysed in a tragic accident waits month after month for a bed in the National Rehabilitation Hospital. A college student at risk of self-harm and psychotic episodes waits in a Dublin emergency department because she cannot get any mental health support in her college. A 70 year old woman waits on a trolley in an emergency department in Limerick for four and a half days.

There is a very brave man called John Wall who is an advocate for medical cards to be granted to people with terminal illnesses. He tweeted the following yesterday: "My public oncologist cancelled my MRI scan last week because after waiting 3 months, I'd no option but to get it done privately." Mr. Wall has stage 4 prostate cancer. He also had his medical card cancelled twice by the HSE, which repeatedly asked him whether he still had a terminal diagnosis.

The public healthcare system is broken. In the words of Tony O'Brien, it has suffered from nine years of governance vandalism. More than 1 million men, women and children are now waiting for some form of healthcare. Children with special needs are waiting three and a half years to see a therapist. Mental health services are now so far beyond breaking point that, in many parts of the country, they no longer exist. So far this year, before we come into the winter, more than 10,000 women and men over the age of 75 will have waited in emergency departments in a chair or trolley for more than 24 hours. For the first time ever, people are ringing GPs and being told that they will have to wait one, two, or three weeks before they can be seen. Every month, 7,000 men, women and children are being added to a healthcare waiting system. This is equivalent to all the men, women and children of a medium-sized town every single month.

This is not normal. Some people ask whether this is not just how healthcare is. It is not how healthcare is. It has never been how healthcare is in Ireland and it is not how healthcare is in any other developed country on earth. In 2015, the Taoiseach, Deputy Varadkar, was the Minister for Health. He made a promise that his Government would bring to zero the number of people waiting more than a year and a half to see a doctor. When the current Minister for Health, Deputy Harris, took over in 2016, the number of men, women and children waiting more than a year and a half was 13,000; today it is 106,000. That means that for every man, woman and child who was waiting for more than a year and a half when the Minister was appointed, there are now seven waiting. The quality of healthcare in Ireland is, by and large, excellent, but quality is of no use if healthcare cannot be accessed. Quality can only be maintained for so long.

Healthcare professionals told the Oireachtas Joint Committee on Health last week that the national programmes are at risk: the national cancer care programme, the national maternity strategy, the national critical care programme, the national mental health plan - the list goes on. This budget should have focused ruthlessly on access. The parts that Fianna Fáil secured did exactly that. Additional funding for the National Treatment Purchase Fund, NTPF, will mean many thousands of men, women and children will be treated next year who otherwise would not have been. One million extra home help hours mean that men and women can be discharged from hospitals to their homes where they need to be, freeing up beds.

Ultimately, however, this is the Government's budget and years of mismanagement have taken their toll. We have the lowest level of hospital consultants anywhere in the developed world. Last week, we heard that last year almost 1,500 doctors deregistered from practising medicine. Just three years ago 500 deregistered. In a few short years the number of doctors deregistering has increased threefold. For every one who left three are now leaving. Hundreds of consultant posts remain unfilled. The agreed safe staffing levels for nurses and midwives have not been reached. Ending new entrant pay inequality for consultants should have been included in this budget. The full year cost is approximately €20 million. Last year, the increase in agency costs was €60 million. Reaching safe staffing levels for nurses and midwives should have been included in this budget. The Taoiseach promised that all graduating nurses and midwives would have jobs in their own country. The de facto embargo means they do not. They are leaving and many of them have little inclination to return.

The Government claims that budget 2020 includes an additional 1,000 healthcare professionals. In the small print however, in the web-based version of the document we got, it states 1,000 healthcare professionals would cost €60 million, we are putting in €10 million but we will put in more in the future. In other words, budget 2020 does not provide for 1,000 healthcare professionals. It provides for approximately 160 extra healthcare professionals. Funding to progress the national maternity hospital and the maternity hospitals should have been included. All three Dublin maternity hospitals should be moving, but in spite of years of promises, nothing is happening.

Budget 2020 contains a huge increase in healthcare spending for the fourth year in a row. Over the past four years healthcare spending will have increased by an astounding €4.9 billion. Somehow at the same time patients are waiting longer, suffering and deteriorating. How is that possible? It is partly down to the overspends. People say overspends are just part of healthcare. Here is the trend for HSE overspends. From 2005 to 2010, inclusive, there was no overspend. In 2016, the overspend was €500 million; in 2017, €200 million; in 2018, €650 million and in 2019, €350 million. The Government's response to this year's overspend is to say the HSE did a good job because it is less than the overspend of last year. It is not less than the overspend of last year because the €650 million overspend of last year is included in this year's budget with no additional targets attached to it. It is like asking someone to go to the shops and buy €50 worth of groceries. They come back and say they got the €50 worth but it cost them €60 and they do not know where the extra €10 has gone. The following week they are sent again and come back saying the €50 worth cost €65 but that is good news because last week they overspent by €10 but this week that has gone up by only €5.

Ireland's public healthcare system is in freefall. Access is collapsing under the weight of what has happened over the past nine years. Men, women and children are waiting and suffering and getting sicker, and this has to change. To do this we have to have enough healthcare professionals. That means ending pay inequality, lifting the de facto embargos and improving working conditions. We need to get spending under control so that extra money means better services. That means multi-annual funding, which does not exist, so that healthcare managers can plan more than a few months in advance. It means collecting basic financial data, which are not collected. As an example, the HSE does not know per hospital how much it is spending per bed night. That is extraordinary. We must get better at using the facilities and assets we have. The diagnostic suites, for example, should be open longer. Healthcare workers and their teams should be rewarded for doing things better. Their successes should be spread throughout the country.

We have to invest in the future. That means new technology for healthcare professionals and patients. Electronic records are essential. That means building the maternity hospitals and getting the national maternity strategy moving again. It means new beds so badly needed in Limerick, Galway, Cork and Waterford, and opening closed beds that are sitting there in Letterkenny and other places. It means teams of GPs, nurses, therapists and mental health professionals working in our communities helping patients manage their health, not telling them they cannot be seen because there are no diagnostics, GP, mental health service or therapists and that when they get really sick they can go into an emergency department and wait like everybody else. We are better than this. We have been better than this. Every other country in Europe is better than this. Budget 2020 gives another €1 billion to the health service. If it is used well and if the other €17 billion is used well, Ireland could have a great public healthcare system. That is what we must all demand on behalf of the men, women and children of this country.

As a man who comes from the nice county of Wexford and knows a bit about agriculture, I am sure the Minister of State, Deputy D'Arcy, knows what a biennial plant is. It takes two years to complete its life cycle and then in most cases, dies, so a new one must be planted. This budget reminds me of a biennial plant. I studied it yesterday and saw several announcements, for example, prescription costs to be reduced by 50%, the monthly threshold for the drug payment scheme to be reduced by €10 a month, free GP care for those younger than eight years, free dental care for those younger than six years, and 1 million additional home care hours. When will these come into operation? I have made the point to the Minister of State that many of these will not come into operation until next September. I cannot understand how any Government is allowed to make announcements about particular improvements that will not come into operation for at least one year. I do not blame the Minister of State because he did not put the budget together, but it is deception, and I use the word with care. It is deceiving people. While here and there we hear it mentioned that some of those items will not be changed until next September, in general the public thinks these improvements are happening straight away.

Carbon tax, stamp duty and other changes came into being on the night of the budget. Why is it not the same across the board? If the Government is going to increase taxes, it does that straight away, but why does it not give benefits to people straight away? That is a crucial point.

I think I was the only Deputy in my constituency who voted for a carbon tax.

I assure the Minister of State that was not an easy thing to do in the constituency of Roscommon-Galway. However my party - and I thank our negotiators and Front Bench in this regard - is looking to the future. Fianna Fáil is looking to the Bord na Móna workers who have been left out on a limb. It is probably 70 years since Bord na Móna became a fantastic employer for people in our region. Soon it will be gone.

Debate adjourned.