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Budget Statement 2021 (Continued)

Tuesday, 13 October 2020

Dáil Éireann Debate
Vol. 999 No. 2
Unrevised

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Deputy Róisín Shortall: Information on Róisín Shortall Zoom on Róisín Shortall This is a budget like no other. It is being introduced in the context of events that are largely beyond our control. Certainly, no one would have chosen the circumstances in which we find ourselves. Covid-19 and Brexit are the twin challenges of budget 2021. How we respond to those challenges is critical.

People who face insecurity, Covid-related and non-Covid health concerns, loss of income and worries about schools and all kinds of services will look to this budget to see what certainty the Government can provide. I think they will be disappointed. There is a need for the Government to focus relentlessly on the public interest and the public good. This means very clear and determined action to drive down the incidence of Covid-19. It means income protection for those who have lost their jobs. It means targeted supports for those sectors most impacted by Covid. It means substantial investment in universal public services. Most of all, it means a budget that offers hope. We entered this pandemic as a country that was ill-equipped to deal with the consequences. This budget is about surviving the ongoing impacts of the pandemic, while also reviving our economy and society to take us through this exceptionally difficult time and on to better times.

We are approaching this task with a radically changed attitude and approach by the European Central Bank, ECB, and the European Commission. It would seem that lessons have been learned at a European level from the last recession. On that occasion, there was an obsession with deficit reduction and responding with austerity, which caused devastation for many people. In this instance, the message is to spend extensively in order to invest and grow our way out of the crisis. That has been hugely enabled by the decision of the ECB to facilitate very cheap borrowing. The spending available in that regard must be done wisely and productively to meet the two objectives of survival and revival.

The consequences of decades of underinvestment in public services and an often cavalier approach to public provision have been laid bare as a result of this pandemic. It was patently clear that leaving key public services to the market - a privatised way of doing things, as practised by this and previous Governments - left us exposed and very vulnerable. The Government parties have come late to the acceptance that we must build up our public services and that we can afford to invest in the future of our society. In the early months of the pandemic, it became very clear just how underfunded and underdeveloped most of our services were. The Government was forced to urgently ramp up those services to enable us to respond to the virus. However, those changes, including the expansion of services, additional funding and the extended involvement of the State, need to be embedded in how we make post-Covid plans for the development of public services. There can be no going back to the kinds of policies which left many people exposed to insecurity. The clear priority and focus must be to provide adequate investment in the public provision of key services, as well as addressing the ongoing deficiencies in how we respond to Covid.

The presence of Covid, the escalation in the rate of infections, the implications and fears associated with the virus and the response to it are things that dominate our lives and are likely to do so for some time to come. Responding adequately, breaking the chains of transmission and driving down the virus while, at the same time, protecting the most vulnerable must be a key priority. Most people are working very hard to comply with the public health advice and the severe restrictions that have been imposed on everyone. Increasingly, however, there is a sense that the Government is not adequately playing its part. Why is it that, seven months in, we still do not have a properly functioning test and trace system? Why did proper staff recruitment start so late? When will we see the rapid turnaround times necessary for the testing system? Why is long tracing not being done to establish the modes of transmission? It is very hard to understand why we have not addressed the issue of travel. Why are we not ready to join the EU's traffic light system with a proper testing or quarantining arrangement? There was no mention of that in today's budget or of the huge difficulties faced by the aviation industry.

Why are we not seeing clear messages tailored to different cohorts to ensure the public health advice is getting through to people? Why, after ten years, is the recommended number of critical care beds not in place? It is very disappointing to see in today's budget that funding has been provided for only 66 additional critical care beds when we know, and have known for the past ten years, that there is a shortage of at least 250. The gross neglect of public health services and the severe inadequacies in the system have resulted, as we all know, in unacceptably long waiting lists and denial of access to timely care for very large numbers of people in our country, in terms of both community and hospital services. These chronic problems in our health service have seriously hampered the country's response to Covid-19, forcing the State to secure additional emergency beds from private hospitals at very significant cost.

New demands on service delivery, infection prevention and control measures and social distancing requirements have put further extreme pressure on a system that was already operating way over capacity. Ireland has never had a fully functioning health service. There has never been any excuse for that and there certainly is no excuse today. The Sláintecare plan to reform our health service was published in 2017 and should now be in its fourth year of funding. Instead, it has never received the kind of substantial funding or backing from Government necessary to implement it. What matters now is what happens next. It is vital that the additional funding being allocated to the Department of Health not only caters for future surges of Covid-19 but is invested in a way that brings about the much-needed system of reform set out in the Sláintecare plan. While the headline figure of €4 billion for the health service is a very substantial one, it is important to look at the detail and note that more than half of that sum is going to fund continued testing and tracing and ensuring adequate levels of personal protective equipment, PPE, as well as other aspects of responding to Covid. That leaves less than €2 billion for the health service, a large proportion of which relates to capital investment about which we were already informed.

The Sláintecare plan sets out two key elements which relate to the very principles of a properly functioning public health service. First, we must ensure that we shift activity away from the acute hospital sector to the community and primary care level. There is very little mention of that today. There is no provision for the additional numbers of staff, including GPs, nurses and therapists, that are needed at community level not only to address the long waiting lists but also to ensure we can achieve the type of reform set out in the Sláintecare plan. The other key element is ensuring we remove the obstacles to people being able to afford to access care. In other words, we must remove the cost element. Again, there is no progress at all on that in terms of extending access to free GP care and medical cards or reducing the cost of medication. It is really important that we move in that direction. Unfortunately, in spite of the lip service paid by the Government to the implementation of Sláintecare, those key elements will not be addressed by what was announced today.


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