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Government has lost the plot on A&E - Ó Caoláin

26 April, 2006


Sinn Féin Dáil leader and Health spokesperson Caoimhghín Ó Caoláin TD has described as "bizarre and self-congratulatory" the motion on Accident and Emergency services tabled by the Government in the Dáil today. Deputy Ó Caolain said the Government had "lost the plot". He called for the provision of the additional 3000 hospital beds needed in the public hospital system and slammed the privatisation agenda being pursued by the Tanaiste and Minister for Health and Children Mary Harney.

Deputy Ó Caoláin stated, "The Tánaiste and her colleagues must take the people for fools. She recently described the situation in A&E units as 'a national emergency'. At the IMO conference last weekend Minister of State Seán Power spoke of the 'perceived flaws' in the health system and said that highlighting these 'helped to create a false impression of a health system in crisis'. So it seems, according to this Government, we have a national emergency but no crisis.

"The reality known only too well to people the length and breadth of this country is that we have had a crisis for years, not just this past winter or since Minister Harney took up the health portfolio. This reality translates into thousands of individual crises for patients and their families. People are being subjected to the dangers and indignities of overcrowded and often chaotic A&E units year on year, with the situation worsening every winter. In the first three months of 2006 there has been a daily average of 300 patients on chairs and trolleys in A&E units.

"There is no mention of a national emergency in the Government motion. There is no mention either of one of the most essential measures needed to address the crisis in A&E and that is a fully resourced plan to provide the additional 3,000 public hospital beds required in the system. That figure is not plucked from the sky. It is in the Government's own Health Strategy published in 2001. Yet there is no plan to provide these beds. We do not even have a proper audit of beds and assessment of bed needs.

"What is the Tánaiste's solution to the bed shortage? It is one of the greatest frauds ever perpetrated on the Irish people. She tells us, quite rightly, that private beds are being heavily subsidised by the State in the public hospital system. Those beds should be public beds. Right again. But what is the Tánaiste's solution? She wants to pour even more public money into the private health business through tax breaks for developers of private profit-driven hospitals and through gifts of land at public hospital sites. She claims this will free up 1000 beds in public hospitals. She does not tell us when or where we will see these beds. And to achieve this alleged aim the Fianna Fail/Progressive Democrats Government is reinforcing the two-tier public-private apartheid in our health services." ENDS

Full statement and Sinn Féin amendment follows:

Dáil statement in full:

We all knew that this Government was in disarray in its stewardship of the health services. But the motion it has put before the Dáil today shows that it has lost the plot altogether. Yesterday there were 331 patients on trolleys and chairs in A&E units in this State. That is the most telling answer to this bizarre, self-congratulatory motion from the Tánaiste and Minister for Health & Children Mary Haney. It would be laughable if we were not dealing with such a tragic situation for people who suffer daily in our hospitals.

The Tánaiste and her colleagues must take the people for fools. She recently described the situation in A&E units as "a national emergency". At the IMO conference last weekend Minister of State Seán Power spoke of the "perceived flaws" in the health system and said that highlighting these "helped to create a false impression of a health system in crisis". So it seems, according to this Government, we have a national emergency but no crisis.

The reality known only too well to people the length and breadth of this country is that we have had a crisis for years, not just this past winter or since Minister Harney took up the health portfolio. This reality translates into thousands of individual crises for patients and their families. People are being subjected to the dangers and indignities of overcrowded and often chaotic A&E units year on year, with the situation worsening every winter. In the first three months of 2006 there has been a daily average of 300 patients on chairs and trolleys in A&E units.

I want to commend the Irish Nurses Organisation for keeping the public informed of this through their Trolley Watch. This is in contrast to the HSE and the Minister's office who wish to conceal the real extent of suffering in our hospitals. I believe we now have a situation in certain hospitals where patients on trolleys are being accommodated in designated rooms or wards; they are still A&E patients - not admitted to a proper ward and waiting for a proper bed - but the patients in these rooms or wards are not being included in the figures for trolley-bound patients on a day-by-day basis.

There is no mention of a national emergency in the Government motion. There is no mention either of one of the most essential measures needed to address the crisis in A&E and that is a fully resourced plan to provide the additional 3,000 public hospital beds required in the system. That figure is not plucked from the sky. It is in the Government's own Health Strategy published in 2001. Yet there is no plan to provide these beds. We do not even have a proper audit of beds and assessment of bed needs.

What is the Tánaiste's solution to the bed shortage? It is one of the greatest frauds ever perpetrated on the Irish people. She tells us, quite rightly, that private beds are being heavily subsidised by the State in the public hospital system. Those beds should be public beds. Right again. But what is the Tánaiste's solution? She wants to pour even more public money into the private health business through tax breaks for developers of private profit-driven hospitals and through gifts of land at public hospital sites. She claims this will free up 1000 beds in public hospitals. She does not tell us when or where we will see these beds. And to achieve this alleged aim the Fianna Fail/Progressive Democrats Government is reinforcing the two-tier public-private apartheid in our health services.

The Tánaiste is pursuing a privatisation agenda. She is rewarding the greed of those who see a health service as a profitable business first and foremost and not as a basic right to which all are entitled equally on the basis of need and need alone.

As the Sinn Féin amendment to the Government motion states, all Government spending on the health services should be on the public system only. The money spent on tax breaks for developers of private hospitals, together with the money wasted on the HSE's failed computer systems, would already have funded an additional 1,000 acute hospital beds in the public system.

When I challenged the Taoiseach recently on the way the A&E crisis is being compounded by the two-tier public-private system he referred to the ongoing talks on a new contract for hospital consultants. We all want to see a new contract that obliges consultants to work in a fully accountable way in the public system and that ensure all new consultant posts are public only. That is long overdue. But what credibility has this Government in those talks when it is pouring public money into the private health system, thus subsidising the private practices of consultants whom the Government claims it wants to work in the public system only? It is inflating the private health business which will attract more and more health professionals away from the public system.

It is obscene that consultants are competing to buy private suites at a cost of €1 million each in one of the Tánaiste's new private hospitals here in Dublin. These have been funded with tax breaks from this Government.

The Tánaiste presented herself as a defender of public patients at her PD party conference last weekend. But we know her real agenda. She spelt it out in December 2004 when she said: "I believe in a minimalist role for the State in all our lives, including health care."

She said it again last June when she said: "The fact that more and more people are getting private health care is a good thing. It's a sign of increasing disposable income."

There is no mention of Primary Care in the Government motion. We hear a lot about Primary Care from the Tánaiste but the commitments made in the Government Health Strategy on Primary Care have not been met. We are still operating a primary care system based predominantly on GPs operating as individual businesses. The promised Primary Care teams and Primary Care centres have not been rolled out. The promised development of out-of-hours GP services has been far too slow. The stunted nature of our primary care system contributes greatly to the A&E crisis. People who cannot access Primary Care services, for whatever reason, are going to A&E for treatment.

Older people who are not getting the care they need at home are becoming ill and ending up in A&E units with conditions that could have been alleviated, and hospitalisation avoided, with earlier intervention.

The A&E crisis has also been compounded by the closure of A&E units in smaller hospitals, including Monaghan and Dundalk in my own region. These services should be restored as part of the overall measures needed to address both the immediate crisis and the longer temr reform of health services.

On behalf of Sinn Féin I reject the Government motion and urge support for the amendment in the name of the Sinn Féin deputies.

Sinn Féin amendment to A&E motion:

To delete all words after "Dáil Éireann" and substitute the following:

- notes the continuing crisis situation in Accident & Emergency units of our hospitals where there have been, on average, some 300 patients per day on trolleys and chairs during the first three months of 2006;

- deplores the failure of the Government, after nine years in office, to alleviate, let alone resolve, the A&E crisis which the Tánaiste and Minister for Health and Children Mary Harney has recently described as a 'national emergency';

- commends hard-working hospital staff who must cope with this unacceptable situation on a daily basis;

- calls on the Government immediately to initiate far-reaching measures to address the A&E crisis which is but the most acute symptom of the fundamental problems which plague our health services; these measures to include:

- a fully resourced and time-tabled programme to provide the additional 3,000 public hospital beds required;

- rollout of promised Primary Care Centres throughout the state on an accelerated timetable;

- restoration of A&E services to local hospitals where these services have been cut;

- a halt to the accelerating privatisation of our health services and all Government health spending to be on the public system only;

- the establishment of a Health Funding Commission to help plan the transition from the grossly inequitable and inefficient two-tier public-private system to a health service with equal access for all based on need alone.

Caoimhghin Ó Caoláin

Seán Crowe

Martin Ferris

Arthur Morgan

Aengus Ó Snodaigh.

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