Speeches
Motion on Accident and Emergency in the Dáil on Wednesday 26th April 2006
Motion on Accident and Emergency in the Dáil on Wednesday 26th April 2006 Fiona O’Malley’s speech.
I will begin by paying tribute to the Tánaiste. I have a vested interest in doing so because she is my party leader, but 15 months ago she took on what is generally described as the most difficult political job.
Her enthusiasm and commitment to the task remain undiminished. It is a tribute to the person she is that she relishes a challenge. She has the courage and the vision and most importantly she is honest in recognising that she does not have the magic wand to provide the solution. She also acknowledges that neither does any other party in the House. She has the vision and the courage, and those are what are required to bring about reform.
We will bore each other recounting the changes that have taken place since 1997 in terms of resourcing, which has increased from €3 billion to €12 billion and will probably be higher next year. The question of resources is a myth at this stage - there is no question mark about resources. I listened to Deputy Moynihan-Cronin's contribution, her reference to the needy and that it is a question of resources, but I disagree. We would have solved all the problems if that was the case. I do not deny that resources need to be applied in different areas but that is a different matter to the reform that is required first of all.
We have a duty as a Government and as a Parliament to get value for money for our taxpayers. It is only natural that we are looking at what has happened to those additional resources that have been ploughed into the health service in recent times. Professor Drumm has referred to the assumption that all the problems can be solved by more capacity, more resources and more money. I am sorry that Deputy Gilmore will not listen to my final point. The assumption presupposes that the system is not at fault, and the Opposition Members, not to mind the public, are fooling themselves if they do not think the system itself is at fault.
I am pleased that Deputy Gilmore has come back to listen to more because I wanted him to hear that point in particular. If that were the case we would just need bigger and more. Deputy Twomey who is a doctor is more familiar than most of us with the service.
It is not politicians, the Government, the Minister or the Department alone that can do this, it must be done in co-operation with the people who work in the sector. It is regrettable that time after time when the Government has tried to introduce initiatives which the IMO wanted, the Opposition has put obstacles in the way. For instance, with the GP visit card, which was initially welcomed by Fine Gael and was to be introduced in the budget, it took a year to finally get agreement on it.
The IMO and the GPs in particular showed there was some issue in play other than patient care in their stand on that matter and that is regrettable. Thankfully the agreement is now in place.
Some of us who are members of the Joint Committee on Health and Children attended the GP-IMO conference in Croke Park recently. A delegate castigated the Government for having introduced a system whereby those over 70 who had not previously held a medical card were now in possession of what is described as a golden medical card worth four times the amount to a GP. It has caused problems in the service. The GP in question wanted me to answer for it. I pointed out to him that this was not Government policy but it was a question of their union deciding that they would not deliver this service and that they would demand more money to provide that service. We all acknowledge the disruption that has been caused in the placing of GPs certainly in Dublin city - I am not sure about other parts of the country. My area is well enough served but I know there are large areas in north and west Dublin where there is no incentive for GPs to provide these services.
I wish to underline the necessity and the importance of putting the patient back at the centre of care and at the centre of the service.
I refer to the nine to five service operating in many hospitals. Medical care cannot be delivered on a nine to five basis and both Professor Drumm and the Tánaiste are trying to change this. I acknowledge that anybody providing a service outside the normal hours should be properly recompensed and that is not a problem for anybody. It is a question of rostering. People in the health service must recognise that 24-hour rostering is essential because services cannot be closed down at 5 p.m.
The recent Tribeca Global Management report cited the request for an extra CT scanner in either Wexford or Galway - I am not sure which. The request was made because the existing CT scanner was not used after 5 p.m. This is nonsense. I know that CT scanners are very costly and, therefore, the country should be getting more than a nine to five service from these machines. As Professor Drumm stated to the committee, these are the things we must do. He said we have paid for a service and we need to ensure it is delivered.
We need to be careful of what we say this side of a general election because if we find ourselves on the other side subsequently, we will not automatically start decrying the health services or, indeed, lauding it. Deputies should be careful about that because it is our national health service to which we are doing damage.
Most importantly, it is the health workers, the people who devote themselves to the care of people, to whom we are doing a disservice.
The patient experience we are most focusing on in the debate is that of accident and emergency. While it has been acknowledged by both the Tánaiste and Minister for Health and Children, Deputy Harney, and Professor Drumm that conditions in some accident and emergency departments are unacceptable, both for patients and for staff, the difficulties in accident and emergency are symptomatic of wider problems in the hospital sector which need reform. In particular, it is about blockages in the system.