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Leaders' Questions (Continued)

Wednesday, 11 February 2015

Dáil Éireann Debate
Vol. 867 No. 2

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(Speaker Continuing)

[Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin] These cases do not illustrate any such flexibility or common sense being applied to genuine situations.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Nobody believes that parents should be stressed or put under pressure in respect of their children. That is one of the reasons the Government has the objective of introducing universal health insurance in the long term. In the short term, nobody wishes to see parents stressed by difficulties with their children. Clearly, a far greater degree of discretion has been applied because 22,000 extra discretionary cards were granted from mid-2014 to the end of 2014.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher They were the cards that were taken in the first place. They are not new ones.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The important issue is whether there is an outstanding treatment, facility or product that either of the two children needs, because parents need to know that they are not blocked from access to the treatment and facilities. In the second case, my understanding is that everything the child requires is being made available. If Deputy Calleary has different information on outstanding facilities or products that are required by these children, he should make it available to the Minister for Health.

With regard to the analysis of the discretion, the Our Children's Health group was outside Government Buildings for a number of months and I met its members on many occasions. They are very reasonable people and they are now working with the clinical team in assessing discretion for treatment and facilities for children. There is local check-back every week. If 22,000 extra cards have been issued on a discretionary basis, I would hope that the HSE could see that common sense is applied to these cases. I do not have all the details of the individual cases because I do not work in the HSE, but is there a product, facility or access to a treatment that either of the two children is not receiving?

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin Just give the card.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny We cannot have a situation where people are put under that pressure. The Keane report was commissioned to report on whether to give medical cards on the basis of an illness and it said that cannot be.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin I have issues with that as well.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Therefore, one goes back to the income threshold and discretion after that. It is in the application of the discretion that the Deputy's question, which is a valid one, must be dealt with. As the Deputy has raised the matter, I hope the people dealing with this can tell us what is outstanding for either of the children in terms of treatment, facility or product.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin The Taoiseach knows what a medical card provides. It gives one access to a GP and to a range of things which this young girl does not have.

An Ceann Comhairle: Information on Seán Barrett Zoom on Seán Barrett The Deputy has put his question. He has had a good run and received five minutes more than his allocated time. I call Deputy Adams.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher Clearly, what is outstanding is the Taoiseach's commitments that he made four years ago.

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams There is growing frustration and anger at the continuing overcrowding crisis in our hospitals. This morning the number of patients awaiting admission is again at near record levels. Some 472 patients were on trolleys in emergency departments or wards this morning, and for the third day in a row Our Lady of Lourdes Hospital in Drogheda has the highest number of citizens on trolleys. It is clear the Government is not providing adequate resources.

Consider the scenario. A patient who is ill presents at a hospital and a clinical decision is taken to admit the patient, but Government policy prevents them from receiving proper medical attention and denies them admission. Instead, they are left for several hours or days on a chair or trolley. I invite the Taoiseach to make an unannounced visit to Our Lady of Lourdes Hospital in Drogheda, or indeed to any other hospital, to see the challenges being faced by committed health workers and the indignities that are being inflicted upon patients and their families. Perhaps he will take the time to visit a ward from which patients have been clinically discharged but who cannot be sent home. It is not safe to send them home because they are denied the services they require as a result of Government policy.

The Government has decided that this is the price our people must pay for its austerity policies. Meanwhile, last year the Government paid €7.5 billion in debt interest, including private banking debt. Will the Taoiseach accept that he cannot and will not tackle the overcrowding crisis in our hospitals while he pursues these brutal austerity policies?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny No, I do not accept the Deputy's assertion. The Government is acutely aware of the challenges and difficulties in the health service. That is why an extra €650 million was put into the system for 2015. It is also the reason the Minister established a specific unit to deal with the emergency department trolley numbers. There were 400 at 8 o'clock this morning, and obviously that will decline during the course of the day. That unit met on 2 February to consider a strategy to deal with this. In Drogheda, for example, there is an acute shortage of beds in the locality to deal with delayed discharges from the hospitals.

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams The Government closed them.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny This is one factor that feeds into the problem. I listened to an eminent medic say this morning that the attitude of the Government is that it will be all right on the day as we have had this problem for years. The fact is, however, that the Government takes this very seriously.

It is not in anybody's best interests to have people on trolleys, particularly elderly people. I have had first-hand experience of going to wards and emergency departments, although I thank the Deputy for the invitation. In the case of Our Lady of Lourdes Hospital, funding was approved for construction of a 12-bed surgical assessment unit and a clinical decision unit which will open next April. The acute medical assessment unit is open 24 hours a day, seven days a week for direct access for GP referrals. The hospital is increasingly making use of relationships with other hospitals in the Louth and Meath group to distribute work more appropriately. A total of 15 transitional care beds were identified this week and five patients have been discharged to date. Our Lady of Lourdes Hospital will be the next hospital to benefit from the Irish hospital redesign programme, and advertisements have been placed to recruit a new hospital manager.

Our Lady of Lourdes Hospital joined the Royal College of Surgeons in Ireland hospital group and will benefit from that networking and reconfiguration in the nearby hospitals, which include Connolly Hospital, Beaumont Hospital, Cavan-Monaghan hospital group and Louth County Hospital, Dundalk. The hospital has been collaborating recently with the private sector to accelerate the exit of long-term care patients, with 24 beds expected to come on stream by the end of this month. The hospital has also implemented fully the improvement plan agreed with the Health Information and Quality Authority as part of the special measures since 2012.

The Minister for Health asked for co-operation from front-line staff and medical personnel, and I thank them for that co-operation. This is an issue that must be managed in a way that will bring about a reduction in the use of trolleys in emergency departments and in the corridors of hospitals, but it is not something that can be fixed overnight. I am anxious that the Deputy understands that the Government does not have endless resources. If it was a question of money, the problem would have been fixed years ago. It is a matter that arises regularly and the issue is to be able to manage it effectively in the interests of the patients. That will be the priority for the Government. The special unit dealing with trolleys in emergency departments will continue to meet and access whatever beds are available, so delayed discharges can be discharged and pressure can be relieved on the hospitals. Again, I thank the medical personnel for their co-operation.

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams The Taoiseach should listen to what he says sometimes. He said it is not in anybody's best interests to have patients on trolleys. There is no need to tell me or anybody else that, particularly the families of these patients. The Taoiseach said there were 400 patients on trolleys this morning, but there were 472. He said a new module unit is being opened at Our Lady of Lourdes Hospital, which is the case, but last week there was no commitment of staff, especially nursing staff, for that unit. He said the hospital is trying to find beds for patients who have been clinically discharged, but at the same time the Government closed Drogheda Cottage Hospital and has yet to honour the commitment regarding St. Joseph's in Ardee.

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