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Budget Statement 2019 (Continued)

Tuesday, 9 October 2018

Dáil Éireann Debate
Vol. 973 No. 2

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(Speaker Continuing)

[Deputy Michael Harty: Information on Michael Harty Zoom on Michael Harty] It offers 100,000 people free care without general practice having the capacity to deliver that. What will it mean? People will end up in out-of-hours services or the accident and emergency department seeking care because general practice does not have the required capacity. Ireland has 64 GPs for every 100,000 of population and in Australia there are 120 GPs per 100,000 of population. Many GPs in Australia are Irish, with over 1,000 doctors in Australia who were trained in Ireland. Taking it as a given that it takes €250,000 to train a doctor, with 1,000 Irish doctors in Australia, it means there has been a gift to the Australian exchequer of €250 million. Taking the number of doctors in Australia, New Zealand, Canada and the UK and extrapolating the cost of educating them, it seems odd that our health service is repelling those doctors and causing them to emigrate. Billions of euro in Exchequer funding goes towards educating doctors who are going to work in different health services because those services provide opportunities to develop career options and give better working conditions and a quality of life.

We will see the waiting times to see GPs lengthening and the amount of time a GP can spend with a patient will shorten. We know 20% of our graduates work outside Ireland, 40% work part-time and 50% are unwilling to take up the responsibility of running a general practice. We can educate as many GPs as we like but the same proportion will emigrate, work part-time or not take up general medical service lists. We know 35% of GPs are over the age of 55 and 20% of those wish to work part-time. These are startling figures and unless we change our system, we will lose those GPs. In last year's budget speech, the Minister stated €40 million would be provided for primary care development, which would allow a number of initiatives to be progressed. He said that in particular, the Government looked forward to further progress on GP contracts and was hopeful agreement could be reached with the implementation of additional services in 2018. However, in that one year, only three meetings took place on the negotiation of GP contracts and nothing happened. I do not know what happened to that €40 million but it certainly did not go to general practice.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Shame.

Deputy Michael Harty: Information on Michael Harty Zoom on Michael Harty There is no reference in the budget speech to bed capacity, specifically to the delivery of 2,600 beds and in that the delivery of intensive care unit, ICU, beds. The lack of ICU beds in the Irish hospital system is inhibiting the rolling out of scoliosis treatment, for example, as the theatres and doctors are available but there are no ICU beds to allow the children to be cared for after surgery. We must expand our capacity in acute hospitals and particularly ICU beds. We must also expand our capacity in community beds, and again there is no reference to how those 4,500 community beds are to be delivered.

The National Treatment Purchase Fund will not fully address the issues facing our dysfunctional health service. Money going into the National Treatment Purchase Fund is important but it is not addressing the fundamental matters of waiting lists or specifically the wait for elective care, which now stands at 74,000. It blunts the matter but it does not address the fundamental problem.

Our health service is locked into its current state for at least the next three years. The lack of urgency in reforming the health service is staggering. In our area in the mid west, the University of Limerick hospitals group has the largest trolley count number in the country, and every day it has between 40 and 60 patients on that list. There is no recognition of the difficulties the reconfiguration in 2008 caused to the mid west and the people in the region will face the same problems they faced this year next year and for two subsequent years.

I will speak to some matters relating to the sustainability of rural Ireland. Although these may not relate specifically to the budget, they are pertinent to the Government policies delivered over the past year. In particular, I refer to the closure of rural post offices. The closure of a post office brings into question the financial sustainability of a community that loses it. There is no question about that, and people in those communities feel they have been abandoned and they are not being valued by this Government.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Hear, hear.

Deputy Michael Harty: Information on Michael Harty Zoom on Michael Harty The fabric of rural society is unravelling. We are losing our post offices and medical services along with our ability to survive. A Programme for a Partnership Government committed to delivering sustainability for our rural post office network but it has failed to do so.

I also refer to broadband, which is a major issue in rural Ireland. This Government has been in power since May 2016 and broadband for rural communities is as far away as ever. Rural Ireland is not a country for young people or young families, as it is now virtually impossible to work at home because of a lack of broadband. It is inhibiting job creation and it is not allowing people to live and prosper in a rural community.

This budget has not delivered because it has focused on so many small tax cuts and small increases in social welfare. Many people in a rural community would much prefer to have a guaranteed health service where they, their parents, grandparents and children would be guaranteed a service. They would forgo these minor changes if they could be guaranteed delivery of a proper health service. I am very disappointed by this budget. It is not sustainable or a long-term plan. It is certainly not sustainable in the delivery of health services.

Deputy Danny Healy-Rae: Information on Danny Healy-Rae Zoom on Danny Healy-Rae I commiserate with the family of Ms Emma Mhic Mhathúna, who have lost a mother and a wonderful person. It is sad to think we are speaking about the health service tonight that was not good enough to save her life and let her down. She was a wonderful person and the people in Ballyferriter made her their own. She was witty and everything that one would ask for in a nice person. Our health service let her down. It is sad to think that nobody has been held responsible for what happened to Emma and many other women like her. If somebody's life was neglected or lost like this in any other system, somebody would be brought to account. It is time to call in the special branches of the Garda to see what happened and get a fair assessment. We must bring somebody to account for what happened in these sad cases. It is sad to think other women are out there with a death sentence hanging over them. They know they will die as well.

The Minister allocated €700 million more to the health service, bringing the total extra allocation for the year to €1.2 billion, but will it make a difference to those people waiting on trolleys? In Kerry general hospital this year there was an average of 25 people day after day waiting on trolleys before they could get a bed. Will it make a difference to people waiting for procedures for hips and knees? These are people roaring with pain for the past four months and we have been asking about their treatment here day after day since we came back. We want the orthopaedic section of Tralee general hospital open again but it is still not open. Will it make a difference to the hundreds of people who still must travel to the North to get cataracts removed? This month Deputy Michael Collins and I will take two buses full of people. We will take two buses in November and another bus in December. We have taken people up all year.

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