Deputy Micheal Martin - speech from 11 Dec 2019

Teachta, my colleague Stephen Donnelly, our head spokesperson, has compiled the most comprehensive picture so far of the number of children waiting for health care in Ireland. It's not a good story, Teachta, and reflects quite badly on the government, because he has put together a staggering list of over 214,000 children waiting for health care in Ireland. 214,000, 117,000 children are waiting for hospital appointments and treatment, and there's another 90,000 children waiting for primary care appointments. One in four children are waiting for more than a year on that list, and these include, Teachta, very sick children in need of urgent surgery. The list includes special needs children in urgent need of therapeutic supports, like speech and language therapy and occupational therapy, to name but a few. And it includes children waiting for psychology, for diagnostic scans, and much, much more. And just to give some examples, in ENT, ear, nose and throat, close to 3,000 children are waiting over a year for an appointment. In terms of paediatric cardiology, over 1,200 children are waiting for over a year for an appointment, out of a total list of close to 5,000. In dermatology, there's an overall list of 4,500, 2,129 waiting for over a year. Ophthalmology, 4,000 children waiting for over a year for an appointment. And psychology, huge figures again, thousands waiting, over 2,500 waiting for over a year, out of a total list of 7,000. And we know the issues of mental health and adolescent mental health as well. And I think this underpins, Teachta, the experiences of many in this house, dealing with many families and parents, exasperated, frustrated, very anxious about the failure to get assessments, failure to get regular access to therapeutic interventions. And we know that early intervention, early diagnosis, treatment is the key to a child's treatment, personal development and optimal outcomes. And worryingly, Teashek, these figures understate the true picture, excludes oral health, for example, and many diagnostic categories are not covered by the HSE. I think it's a terrible indictment on our health service and on the government's stewardship of that. There's a shortage of consultants, therapists and specialist nurses. And there is currently in place, Teashek, despite what you say, a moratorium on recruitment. So I want to ask you, Teashek, in relation to this, will the government remove the hiring embargo to enable the fast recruitment of doctors, therapists, radiographers and so forth? Will you remove the new entry pay inequality for consultants so we can hire the number of specialists we need? Will you accelerate the hiring procedures for such specialists and clinical staff that we urgently require? So take radiographers, chronic shortage in Temple Street. And basically, Teashek, I ask you, in the interim, will you accelerate the provision of additional hospital beds for children, particularly in ICU, in rehab and ward beds across the system? Teashek. Thanks, Deputy. I just wanted to say at the outset that I think it's very sad that there are so many people and so many children on waiting lists for health care and for therapies. It isn't good enough. I know that. And I feel that very much in my constituency work and in the parents and children that I meet from time to time who tell me of their personal stories. But I think it's also only right that we in this house acknowledge that waiting lists in Ireland for health care are now actually falling. So if you look at the waiting lists for outpatient appointments, people waiting to see a specialist, the NTPF figures show that they've now been falling for three or four months in a row. It took years and years of investment and additional staff, but we're now finally seeing those outpatient waiting lists falling. They've fallen now consistently for three or four months in a row. That's people waiting to see a specialist. When it comes to people waiting for an operation or a procedure, for example, back when I became Taoiseach two and a half years ago, there were over 60,000 people waiting more than 12 weeks for an operation or a procedure. That's down to around 38,000 now. So down over a third in two and a half years. A lot of that is down to the investment to the NTPF, which I know you were very supportive of and advocated for. We also see that the waiting times for general paediatrics are down about 30% so far this year. And that's because of the new urgent care centre that's been opened in Connolly, which has a dedicated paediatric outpatient department. And that's a big turnaround in one year. And we're also seeing, for example, in CAMHS, Child Added Mental Health Services, where the waiting list is down about 20% in the past year. And that isn't down to any waiting list initiative. It's down to structural changes that have been led by Minister Daly in employing a large number of assistant psychologists, moving away from a psychiatric model to a model that is more based on psychology. So that's real progress. Outpatient lists now falling for three or four months in a row. Inpatient procedure lists down about a third on where they were two and a half years ago. General paediatrics, and I know it's only general paediatrics, but that's an important part of paediatrics, down 30% in the past year. CAMHS down 20% in the past year. It took years and years of investment and additional staff to reverse the damage that was done. But I'm glad that I can now say and stand over the fact that waiting lists are now falling in Ireland and not increasing after a very long time of them going in the wrong direction. So what are we going to do about it? We're going to continue to invest. There's an additional billion euros in the budget for the HSC next year. As I mentioned, the Conley Centre is opened, and that is helping already. But we need to get that opened at weekends and into the evenings as well. And we're working to do that in 2020. The Urgent Care Centre in Tala for Children will open next year, and that's a big step forward as well. And then the Children's Hospital itself, the main new Children's Hospital on the James' Campus, with an individual room for every child and room for a parent to sleep in every room, will open in 2023. And after so many false starts, including 35 million wasted on the Matter Project, we now finally have that hospital at roof level with the windows in already on one level. And we're particularly working on moving speech and language therapy into schools, which I think is going to work out. But that's only started now. We'll see how that pilot plays out. Once again, to answer your question, there isn't a moratorium on improvement. We have 15,000 more staff in our health service than we had a few years ago. We have more staff in our health service than we had this time last year. So managers can fill positions so long as those positions are budgeted for. In relation to consultant pay, this is something we're working on at the moment. And we are willing to make an offer to doctors when it comes to consultant pay, that we will give full pay equality for consultants, provided consultants commit to working in the public service and the public service only. And that will be the first step in our plan to remove private practice from public hospitals. Deputy Martin has one minute. The first point I would make is this, that you do acknowledge the fact that it is shocking that so many children have to wait so long. And you instanced a treatment purchase fund. That was brought in against your best wishes. Minister O'Reilly got rid of the treatment purchase fund. He didn't have to get rid of it. He got rid of it because of his own ideological position in relation to it. And it was a disastrous decision. And it took confidence and supply to restore treatment purchase fund. But that said, you still are in denial about the recruitment embargo. I have here, Taoiseach, in terms of an audiology post, advertised in July of 2018. A key post needed in the southern part of the country. I'll move on to July 30th, 2019. The same individual had to give up a private sector job on the belief that they had a contractual arrangement. The post is unable to be processed. This is July 30th, 2019. We're now until the end of Christmas. And it still goes on. No time frame, it says here, as to when the pay bill controls will cease. This is from the HSE. Taoiseach, there's been an active moratorium on key posts. Look at Temple Street. I think there are 30 posts approved for Temple Street, 30 radiographers. I think we have 17 in position. 19 in position. So there is a moratorium, Taoiseach, and that has been over the last 12 months. And that has exacerbated this issue. And in terms of pay inequality, that's gone on for the last number of years. And I would put it to you Taoiseach, you get partisan about the children's hospital and root level and the matter and all of that. No one in this house can dictate the planning process. No, I'm just making a point here. For the payardons. It's a serious matter for the payardons children. Of the children concerned here. Telling them that we're at root level is of no consequence for a mother and a father who want to get a psychology appointment, who want to get urgent appointments in terms of hospital outpatient treatment and in terms of the therapies. Ask anyone in the house, Taoiseach. The waiting times for therapists is shocking, is appalling and continues to be the case. No wonder I've been criticised. Listen, I'm here to implement the rules. Well, that's fine. I'm here to implement the rules. Taoiseach. First of all, I do want to welcome the Deputy's acknowledgement that there has been a considerable reduction in patients waiting for operations and procedures. About a 30% reduction in the last, since the middle of 2017. And on a bipartisan basis, I want to acknowledge that investment through the NTPF has actually worked. I know those on the left have an ideological objection to using NTPF. But it's something that we did together, Fianna Fáil and Fine Gael. And I'm glad that it has worked. And I'm happy to acknowledge your role as a party in encouraging us to increase funding for the NTPF, which has now worked. And has a means that the number of people waiting more than 12 weeks for a hip replacement, a knee replacement, tonsils, veins, angiograms, all of those things, is about half what it was, as recently as the summer of 2017. On the moratorium, there isn't a moratorium. Any post that's funded can be filled. And there are more people working in our health service than there were this time last year. And that is just a simple fact. In relation to pay inequality for consultants, let me answer your question again. Now, we've discussed this, me as Taoiseach, working with Minister Donoghue, working with Minister Harris. And we are willing to make an offer to consultants that we are willing to fully reverse pay inequality, but only for what are called type A posts. We want full pay equality for consultants, but only if they commit to working in the public service only. And that will be the first step towards disentangling the public-private mix that exists in our public hospitals in line with the Saundra Care vision. And I hope they're up for it. Thank you very much.