Mattie McGrath demands review of Tipperary patient transport cuts

Good morning, everyone. I'm going to talk to you in the UK, and I'm going to talk to you in the UK for granting me this topic, albeit after midnight. There is a very concerning issue affecting the lives and health of many vulnerable people across the country of Tipperary, the unacceptable and short-sighted cuts to hospital patient transport services. For many in rural areas of Tipperary, especially the elderly, the sick and those on low incomes, access to hospital appointments in places like Canmel, Limerick, Cork, Waterford and indeed Dublin, depends entirely on the patient transport services provided by the HSE or indeed by voluntary organisations, which I salute for the work they do like the Red Cross, Civil Defence and the Order of Malta. These are not luxury services, but they are essential lifelines. They have been contacted by families, carers and community groups who are at breaking point. They are being told that transport is no longer available, that services are being rationalised, that lovely word, and in some cases that patients must find alternative arrangements, but what alternatives do they have in rural parishes? Public transport is, in much of Tipperary, is limited or non-existent. Many of those patients are already frail, wheelchair users are recovering from major surgeries. They cannot drive themselves. They do not have family or family members that may be walking or living around, or they may be living abroad. The result is, missed appointments, delayed treatments and worsening conditions, and ultimately pressure piled back on our hospitals due to avoidable admissions to A&Es. I had one case where a man waited four years, four years minister, 48 months, for an appointment. He has no family, his neighbour, who used to bring him to his appointments, had passed away a month ago, and he had no one else to transport him to Cork. He was too frail to use public transfers, as it was non-existent in the first place. In any event, a taxi would cost him €120, half of his pension gone in one appointment. Such a shocking situation, minister. Another case of a woman whose daughter is paraplegic and requires an ambulance transfer. This woman literally had no other option. She could not just get a neighbour to drive her. In the end, she was forced to beg a voluntary organisation to get them to transport her daughter to a vital appointment, which did happen, and thankfully for that, for the volunteers and the voluntary ambulance. Minister, this is not a question of convenience. This is about dignity, quality of access, and the right to timely medical care, regardless of your address or need income. I want to ask you here today, minister, who made this decision, unilaterally, to cut this without any engagement? Why was the cuts made with no public consultation, no DAW debate, and no local engagement or engagement? Where is the assessment of the human cost to this? And indeed, will the minister commit to immediately reviewing the criteria for access to patient transport services in February, with a view to restoring full service? How can faceless bureaucrats decide this? When I came in here in 2007, the agency had a budget of around £7 billion. Now it's £24 billion and growing every year. How come it's the most vulnerable? We had a five-hour debate here today about what Carol Darmony was here with her dad, with people's access to and the HSE, breaking the law on a daily hourly basis and not doing assessments of needs. So why are we going to allow this cabal in the HSE to run amok, do what you like, neglect people, and flout the laws? First of all, I want to thank you, Deputy McGrath, for, you know, I suppose what you brought up tonight highlights an issue that it's a concern. And I just want to give you an update on the patient transport in County Tipperary. So the patient transport service, which provides non-emergency patient transport for some patients in the Southeast region, was set up, Deputy, in 2013. It was set up on a discretionary basis by the HSE for the Southeast region. Hospitals in this region were given a budget to provide limited transport for patients to attend other acute services. The cost of providing the non-emergency patient transport services has increased year on. And the cost for providing these services has grown from just over £88,000 in 2019 to over £127,000 in 2024. Due to this continued increase, Tipperary University Hospital has had to review the eligibility criteria for patients applying for access to the service. The review of the eligibility criteria is aimed at preserving the valuable service so that those most in need and the vulnerable patients can access it. It is important to emphasise that those patients travelling for radiation therapy or chemotherapy will not be affected by these changes. And that's important to clarify today, Deputy. There are a number of criteria which need to be taken into consideration by Tipperary University Hospital when assessing a patient's eligibility to access the service, including the patient's exceptional medical need and the patient's age, 75 years and over, mobility, appointment and so on. The Government fully acknowledges the concern and inconvenience for patients and their families that these changes have made to Tipperary University Hospital. And it continues to accommodate the patients most in need of this service in line with the revised eligibility criteria. The hospital robustly assesses patients' eligibility and all patients must meet the revised criteria before being approved for the transport. So it's actually to the HSE deputy. The assessment of patients' eligibility for non-emergency patient transport services is determined by the local HSE service, who aims to provide those most in need of access to this valuable service. The Government has invested significantly in Tipperary University Hospital and the budget for the hospital has increased from almost £81 million in 2020 to over £122 million in 2025, a significant increase of 51% in this time. Staffing deputy has also increased by 25% since 2020, from £968 to £1,212. The cost of providing this important service has increased year on and it aims at assisting those most in need. So thank you, Deputy. Mr. Duke, I remember six months ago you were in opposition, you were like myself, crying out about this. It's not a massive increase, it's an £88,220 over since 2013. There's nothing in the scheme of things. And you're missing all this to staff. I want to know how many of them are pen pushers, executives, going around with creative jobs, making up jobs. That's what they are. Not nurses or frontline staff. And it's a shocking situation. I stood in town, Melon, in front of St. Joseph's Hospital. We're opening, sleeping in one wing. I want to go now. And I'm out of new executives. Many from your area. No disrespect to them, but positions that we never had before. Executive of directors and directors of this and directors of that. Directors of everything except patient care. So we're taking on people. Of course we are. In managing jobs. Self-serving officials. This is what's wrong in the HSE. And we have spineless ministers that won't challenge them. We've been five hours a night talking about it here. All sides of the house condemning what's going on in the HSE. And then we have this mean, hungry, desperate cuts to people who are vulnerable. Thankfully, they'll get collected for radium or other treatment. But what about the person as a paraplegic or as an amputee? Or what about the people who have severe diabetes or many other conditions? So we're picking and choosing who's sick and who's vulnerable. While cats getting fatter. And we have the board members of the HSE. And we have the Rueck Hospital of the Children's Hospital. And the absolute disgrace for diabolical lack of management. And lack of accountability. And we make these mean cuts. We're talking about a roughly dozen cuts. It was a Charlie McPheeby back in the past. This is so mean. So mean-spirited. And we expect voluntary organisations to order more to civil defence. And indeed, as I said, Red Cross. To burn out their amuses. Burn out their staff who are volunteers. And while there's, as I said, officials and fat cats going around to conferences. And everything else would vote. Bring back the maters to the hospital. And make the savings that they are. And have the hospitals clean. And not have predators of management who are not managing. They're in Cape. They were never managed in the first place. Some of them have gone into those jobs pulled in by pull. And it's a shocking situation that we can treat people like this. Vulnerable people in society. And you can't argue against it. First of all, again, I want to thank you, Deputy, for raising this issue and providing with the opportunity to update you on the transport in County Tipperary. And I think it is important, Deputy, when you mention the Red Cross, Order of Malt and Civil Defence, that we pay tribute to the great work that they do. They're absolutely excellent. And, you know, I think it was important that you recognize them, that we all recognize them tonight. But I can assure you, Deputy, that the HSE and Tipperary University Hospital are committed to providing high-quality service in response to the local needs. Tipperary University Hospital has reviewed the eligibility criteria for the non-emergency patient transport service so that the most in need and vulnerable patients can still access this. And as I said earlier, Deputy, the non-emergency patient transport calls are planned for patients who require transport in a special converted taxi or minibus to attend pre-arranged medical appointments and who do not require a stretcher-equipped vehicle. The patient transport service set up in 2013 on a discretionary basis by the HSE provides non-emergency patient transport for patients in the south-east region hospitals. And, you know, there is a budget there. I do understand your concerns, Deputy, I really do. I will go back to the HSE for you and see if, you know, it can be looked at. I will do that because I do understand that there is vulnerable people out there. And it is important to reiterate that this is HSE-led and, as I said, thank you for highlighting the seriousness and the concerns that you have raised tonight. Thank you very much.