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Ó Caoláin expresses no confidence in health minister

18 September, 2012 - by Caoimhghín Ó Caoláin TD


Speaking in the debate on the motion of no confidence in Health Minister James Reilly, Sinn Féin Health spokesperson Caoimhghín Ó Caoláin said:
“Since he took office, and indeed before it, Minister Reilly has made great play of his determination to take the reins in his own hands and to take executive responsibility back to his office from the HSE. Indeed, he has legislated accordingly.
“But where was Minister Reilly when the €130 million cuts were announced on 30 August? He left it to the HSE to be the bearers of bad news. He was nowhere to be seen and he had to be smoked out of hiding to answer to the media and the public.
“I want to commend the people with disabilities who camped outside Government Buildings and demanded the lifting of the cuts to Personal Assistants. They secured an apparent climb-down by the Minister and the Government – but we must wait and see how that works out in practice.
“How was such a cruel cut ever approved in the first place? Are we expected to believe that this was not approved directly by the Minister? Are we to believe that the detail of this major package of €130 million further cuts in public health services did not cross Minister Reilly’s desk?
“If it did not cross his desk then the claim that he is a hands-on Minister who has taken the reins from the HSE is spurious. If he did sign off on these cuts then he bears responsibility for causing distress to the most vulnerable of our citizens. And then to have to climb down in the space of less than a week shows what can only be called chaotic management of our public health services.
“Unquestionably Health Minister James Reilly and his Fine Gael and Labour Cabinet colleagues are plunging the health services into ever deeper crisis with the savage cuts now being imposed.

PMB 18.9.12 - Motion of no confidence in James Reilly TD
Caoimhghín Ó Caoláin TD, Sinn Féin Health Spokesperson.

The Sinn Féin deputies have no confidence in the Minister for Health James Reilly and we deplore this Government’s attacks on our public health services and its fundamentally flawed health policy. We will be voting accordingly at the end of this debate.
Ar dtús molaim an leasú in ainmneacha na dTeachtaí Sinn Féin. Ní leor an rún ó Fhianna Fáil, páirtí a chur ciorraithe ar seirbhísí sláinte i bhfeidhm nuair a bhí siad sa Rialtas.
This motion was prompted by the €130 million in further cuts announced by the HSE on 30 August. This reduction was on top of the over €750 million taken out of the Health services in Budget 2012.
Among the cuts announced on 30 August were further restrictions on overtime and the use of agency staff. Of course additional overtime and hiring of agency staff was made necessary by the ongoing recruitment ban. Despite vocal their opposition to it prior to the General Election this Minister and his Fine Gael and Labour colleagues have not lifted that ban.
We warned that such cuts would compromise front-line services and this is exactly what’s happening now.
Lead Clinician at Our Lady of Lourdes Hospital, Drogheda, Michael Staunton, in a letter to the HSE in the past week makes clear that the cuts will have a very serious effect on the Intensive Care Unit and on operating theatres. In both cases services will be significantly reduced for patients and Mr. Staunton states with authority that it may have the effect of “increased morbidity and mortality of critically ill patients”.
The cuts in the Lourdes will mean the closure of 16 in-patient beds, closure of one operating theatre for 5 to 6 weeks, closure of day ward beds at night and at weekends, closure of one operating theatre for 5 to 6 weeks, closure of one Intensive Care Unit bed, reduced opening hours for the Acute Medical Assessment Unit, closure of beds in Louth Co. Hospital, Dundalk for ‘clinically discharged’ patients from the Lourdes.
The Lourdes is the main acute hospital in the North East region covering Counties Louth, Meath, Cavan, Monaghan and also accepting many patients from North Dublin. For these cuts to proceed would be to put the lives and health of people in this region at risk. We demand that these cuts be stopped and stopped now.
And this is just one region. The reality of savage health cuts is replicated across all HSE regions.
Since he took office, and indeed before it, Minister Reilly has made great play of his determination to take the reins in his own hands and to take executive responsibility back to his office from the HSE. Indeed, he has legislated accordingly.
But where was Minister Reilly when the €130 million cuts were announced on 30 August? He left it to the HSE to be the bearers of bad news. He was nowhere to be seen and he had to be smoked out of hiding to answer to the media and the public.
And what an announcement it was. Homecare packages cut. Home help hours cut. Agency and overtime cut and no lifting of the recruitment ban. Personal Assistance for the Disabled cut. Truly appalling.
I want to commend the people with disabilities who camped outside Government Buildings and demanded the lifting of the cuts to Personal Assistants. They secured an apparent climb-down by the Minister and the Government – but we must wait and see how that works out in practice.
What I want to ask this Minister and this Cabinet is how such a cruel cut was ever approved in the first place. Are we expected to believe that this was not approved directly by the Minister? Are we to believe that the detail of this major package of €130 million further cuts in public health services did not cross Minister Reilly’s desk?
If it did not cross his desk then the claim that he is a hands-on Minister who has taken the reins from the HSE is spurious. If he did sign off on these cuts then he bears responsibility for causing distress to the most vulnerable of our citizens. And then to have to climb down in the space of less than a week shows what can only be called chaotic management of our public health services.
Unquestionably Health Minister James Reilly and his Fine Gael and Labour Cabinet colleagues are plunging the health services into deep crisis with the savage cuts now being imposed.
This Minister has claimed, incredibly, that the health cuts in Budget 2012 did not lead to loss of services, despite the fact that hospital and nursing home beds have been closed and services reduced across the hospital system.
Existing home help, homecare and personal assistant services are insufficient to meet the need that is out there, yet now they are to be further reduced. Yet the HSE and Government are also slashing the numbers of public nursing home beds and claiming that the priority is to keep older people living in their own homes.
Around 300 public nursing home beds have been closed this year so far. Some 600, mostly older people, are in hospital beds and ready to be discharged but awaiting care places. 2,400 public acute hospital beds currently closed.
We had the further revelation in the past week that the promised provision of free GP care to people on the long-term illness scheme may be delayed by at least a year.
The extension of free GP care to all, beginning with people on the long-term illness scheme, was supposed to be a corner-stone of the Fine Gael/Labour Coalition’s health reforms. Free GP care for long-term illness patients was promised by Minister Reilly for 2012 but we now find that it may be delayed by at least a year.
Legal issues are being cited for this delay. If this is the case it is incredible that it took more than a year in Government for the alleged legal difficulty to come to light given that the commitment to start the roll-out of free GP was a Fine Gael and Labour promise from long before the 2011 General Election.
Many will suspect that the alleged legal difficulty is a convenient excuse to cover a retreat brought about by the financial crisis in the Health sector, a crisis worsened by this Government’s policies.
If there is a real legal difficulty then the whole basis of the promised reforms of Minister Reilly and his Coalition colleagues is in question and they must be challenged on their failure to provide a proper legislative foundation for those reforms.
The spending over-run in the Health budget this year was utterly predictable because the amount of money cut from the Health budget for 2012 was totally unsustainable. Some €750 million was taken out of health in the Fine Gael/Labour Coalition Government’s Budget 2012. €1 billion was taken out of health spending in 2011 and the Department of Health is talking about an overall reduction of €2 billion up to 2014.
The Fine Gael/Labour Government puts the diktats of the Troika before the old and the sick and people with disabilities in Irish society. How long will they continue to run our public health services into the ground?
And as we are debating a motion in the name of the Fianna Fáil deputies, it is well to point out that there is an Irish Troika – the Troika of Fine Gael, Labour and Fianna Fáil, who are at one in their support for the futile economic strategy of austerity. The Fianna Fáil motion is carefully worded because that party agrees with austerity and cannot fully oppose health cuts based on austerity, not to mention their own appalling record in office from 1997 to 2011. They had the opportunity to transform our health services but squandered that opportunity just as they squandered so much else that could have made for a better society in Ireland.
The contracts concluded with the hospital consultants by successive Fianna Fáil-led Governments can only be described as scandalous. The talks concluded yesterday may begin to redress the balance but it is surely a mountain to climb.
It is not enough to point to the failed policy of this and previous Governments. Alternatives are needed. We in Sinn Féin have set out those alternatives. Six years ago we published a radical health reform plan. Every year since in our pre-Budget submissions we have set out ways in which services can be protected and a new beginning made.
To focus on funding alone, savings can be made without attacking front line services. We in Sinn Féin have proposed such savings. For example:
Applying charges based on the full economic cost for the use of beds in public and voluntary hospitals in the state for the purposes of private medical practice. would save over €370 million.
The full generic substitution of medicines under the GMS scheme and a clamp down on over prescriptions could €200 million. We acknowledge that legislation in this regard has been published and is now in the Seanad but more needs to be done – especially to combat profiteering. A recent survey showed that the HSE and patients here are paying up to 12 times more than the NHS for the same generic drugs. If that issue is not addressed the savings from generic substitution will not be realised.
There must be a major change in both economic strategy and health policy or we face complete melt-down in public health services in this State.
The first step is the resignation or removal of this Minister followed by the reversal of the cuts and the adoption of a health policy based on fairness and equity and access for all. ENDS

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