Mattie McGrath: Demands stronger A&E and mental health support

Deputy Matty McGrath, Deputy Deputy Matty McGrath I am happy to speak on this bill here this evening, which seeks to give effect to the taxation changes announced on Budget Day. Section 2 of the bill provides that the reduced rate of universal social charge for full medical cardholders whose individual annual income does not exceed £60,000 will be extended for a further year until the end of 2020 tax year, and I welcome that of course. We know from the ESRI that income tax, including the universal social charge, is the largest individual source of tax revenue in Ireland, accounting for over 35% of the total. Thus, fluctuations in the increase of the source of revenue has a significant bearing on the total tax pay. I know the budget was framed in the Minister's opinion to say it, and the Finance Bill, with an eye over her shoulder or two eyes maybe looking at straight ahead of what is happening across the pond in England regarding Brexit. But nonetheless, I think to go to collect any form of imagination, or indeed real effort, to look after ordinary people and ordinary families. I want to say, however, about broader health-related measures being introduced. We know that the Minister is providing for a €25 increase in the weekly income threshold for GP visit cards, and a 0.50 reduction in the prescription charge from €2 to €150 for a medical cardholder over the age of 70. We also know that there will be a €10 reduction in the monthly drugs payment scheme threshold from €134 to €124, and we have to welcome those moves. All of these are welcome, even if we believe that a more ambitious movement could have been made on each of them, and I certainly believe that it could have been far more ambitious. I would ask for some clarity on whether or not funding has been considered that enables us to waive or reduce the fees for accident and emergency care for children who suffer from conditions which necessitate regular attendance at hospital, accident and emergency units. I think that's very important, Minister, because if you have a sick child and they're prone to, you know, getting urgently or quite seriously ill quite quickly, they need to be able to get access to any, and they need to be able to have the charges waived. We have another situation where we had a 74-year-old woman yesterday who was knocked off a trolley by a drunk. Something has to be done regarding, you know, these people, whether it's drunk or whether it's drugs or whatever it is, causing mayhem and bedlam. And we're paying security to try and protect our frontline staff, who must be protected and should be protected. But I think we'll have to look at something, that those kind of people will have to be taken elsewhere and taken into, I have an idea where it's in them, but I mean, if they're repeat offenders especially. Guard the time, security time, everyone's time taken up. And the terror that they perpetrate on the whole A&E and the hospital and patients, young and old, it's just not acceptable. And we shouldn't be pussyfooting around it. We have to deal with these people because they're repeat offenders and they don't seem to care what kind of mayhem or bedlam because they want to damage their own lives and help into it. I'm not saying, lock them up and throw away the keys. I'm saying we need to protect our A&Es, they're under savage pressure and we need to deal with the people we should deal with. When I raised this matter with the Minister, he said that health outpatient charge regulations will continue to insist that the charge shall be only made in respect of the first occasion. The service, that's what I'm saying, of a child going to A&E is provided in relation to each episode of care. But it's not, there's no clarity and they are being charged. I would like to see this question here in terms of the full waiver for those who simply cannot afford the fees. And if it's for that sake, they have to go to A&E. Minister Donoghau also announced that an additional £84 million will be provided for mental health services in 2019, bringing the total available funding for mental health to £1 billion, an increase of 9%. And I see Deputy Healey is in the Chamber as well and will be speaking afterwards. The mental health situation is appalling. And we have found in the last several years that the full budget hasn't been spent, where it's supposed to be spent and hasn't been appropriated. I want to put it in a minute that very little of that £1 billion must be making his way to Tipperary. As we're still without a single residential psychiatric bed for the entire county. And indeed our crisis house is still not being adequately provided or being brought forward. We have promises and promises and promises. And we can't live on promises. We can't live on the wind. And the people of Tipperary are entitled to have some modicum of mental health services as well as any place else in the country. And it's just a scandal, Minister, that we don't have any place for these people to go. When they get a psychotic episode or are feeling bad, I have to go into A&E. We can't even get a shawmrah. We're not even one 8x8 room in our hospital A&E. And they will have 40 new modular units. Now we can't get one of them. For people who can't be allowed to sit in A&E in all that trauma and be a triad or anything else, they must be, for their own health and for their own sanity, they must be allowed to be in some place that is less stressful, less busy, less noisy, less devastating. And we have cases, we have cases who have been sent away from A&E and sadly, sadly, sadly, sadly, have ended up in their graves. And this is the A&E's not able to cope. So we lost our psychiatric services in St. Michael's in Clannemain. Indeed we lost St. Luke's before that in our long state. But we need some service and lip service all we're getting. And I do believe Minister Daly is doing his best. But his best is not good enough because he can't deliver. And I do believe that he's frustrated with it. And they have accepted all in sundry in the HCC and all the different regional areas that we're short of these 12 to 15 long stay beds. We don't have a single bed. We're sent to Kilkenny. It's the hell out of Kilkenny. You speak to Hill out of Connacht because Kilkenny can't cope with the numbers that they have from the south-east region. And in north of the border we're sent, north of the south tip border, north tipperary, we're sent to Innes. Bypass Limerick. We're almost in Connacht at that stage. So the Hill out of Connacht is very after this government. He don't care about the people. And you must look after them because they're the most vulnerable. They're the people that need it. And all they need maybe is a small bit of counselling. And with Dr. Alan Moore and others have said, if we could provide the 24 hour on duty nurse, specialist nurse, a lot of this could be avoided. That they could meet the specialist nurse who understands their predicament, who's able to deal with, who's trained. And I'm told that those people are ready, willing and able to, and have applied and have been accepted for the job. But there's no money to pay them. So where is this one billing going? You're paying a trickling new job here, Minister, and it's too serious, especially with mental health. I also understand from the Minister that the total funding for the National Treatment Purchase Fund, NTPF, will be 75 million in 2019. However, this must be seen in the context of the record 564,829 people who are awaiting a hospital outpatient appointment at the end of July. An increase of 4,578 when compared with June, according to data from the National Treatment Purchase Fund. Have you any shame, Minister? Are you totally shameless? These figures are just growing and growing and expanding, and you stand up here and claim credit for what you're doing with the economy, what you're doing. If you can't look after the people who are sick, God help us. As I understand it, numbers have increased 10.4% year on year, with 511,675 patients on the list this time last year. Since the start of 2019, an additional 48,667 people, patients, have joined the waiting list figures to figure show. It's just incredible, it's big as belief. You can rattle off the figures, but every one of those is a real person, with real issues, real health issues. This is absolutely scandalous, especially when we consider that the 2019 capital provision for health will amount to 670 million next year. We also know that people in the need of HSE home care are waiting longer than two years, in some cases. Indeed, it is reported that pensioners are now finding it more difficult to access home care than a decade ago. And we have a million extra hours announced in the budget, but it's going nowhere. It won't keep us even standing still. We need three million. The problem we have now is we can't get people to do it because they're fed off of being burned out, running around the country in their own care, and trying to be debility jacked and need the Tom to Mary in the same two hours, or maybe 20 minutes or half an hour each. It's just an insult. And our people that are looking after this in our area are doing their best, but they just don't have the go-ahead. And if they get a package approved, it's not cleared. And there's a recruitment ban, and you're hiding behind that, but it is there. This has been confirmed previously through an investigation conducted by the Care Alliance Ireland. Care Alliance Ireland Executive Director Liam O'Sullivan has estimated that there's a gap of 18% are 4 million care hours. 4 million care hours. Not 4, not 400, not 4,000, 4 million care hours between what is needed and the service people receive. What are we doing to the people that built up this country, that gave us all the bloody bread that we can breathe, and gave us a living here? What are we doing when we celebrate with the Cancola in 2019, back in January, our inception as a 100th anniversary of our own sovereignty? My goodness, it's shocking. What has the Minister provided this bill that will deal with the awful situation from getting any worse? The Carers and the Carers, and we pay lip service to them, and families need them, and they're freeing up hospital beds. I'm relieved to see that the bill provides for continuing extension of young trained farmers' stamp duty relief, up until the end of 2021 only. This relief provides for a full exemption on the stamp duty on transfers of farmland to certain young trained farmers. This exemption from stamp duty is designed to encourage the transfer of farmland to a new generation of farmers with relevant qualifications. Transfer may be a way of gift or sale, and that is so badly needed that we move on and get younger farmers involved and keep them involved and interested. In order to be eligible, the farmer must be under the age of 35, on the date of the deed of transfer and must also have attained one of the necessary qualifications, and that's fine. The young trained farmer must also have spent no less than 50% of his or her normal working time farming the land and retain ownership of the land. In my county, they can't because the hell of the conduct is inoperated. I asked you in my budget submission, I've asked you in the last five years, to put a massive tax on the condomers, in my case, a horse industry, a wonderful horse industry we are very proud of, but they can't buy every piece of land. Everything the size of this capital in the area they are buying it now, and they will give no chance to any young family, any young farmer, yes they will throw money at communities in support the GE and the soccer pitchers and everything else, but it's a false economy. Because if we don't have families and people living in the area to support the villages and the area, we are wasting our time, we won't have schools, we won't have the numbers, we won't have teams, and we won't have any living. And they have fenced them all and bulldozed ditches and trees, and then fenced them out, a snipe wouldn't get through. In the days of the old landlords, the farmers and the workmen got milk and got Ames and got every kind of food going over themselves, not a snipe won't get through. Security gates then with flashing lights, securing the area, cutting the combines roll in, three and four massive combines, to hand security to mind them, and ye are in hock with them, and ye are supporting them, because ye were all bussed down to Manila when ye took over in 2011, and brought over around Coole Moor for the whole two days, looked after them. They have deep pockets, and ye are inside them, but my god the people are waiting to see ye. I've been very calm, but it's fact, I'm not straying, ye are straying when ye were out down, they were always had Fianna Fáil in the cosh, but now it's ye. Tweedledum and Tweedledee, and to help with the ordinary people. I do accept that after the Budget last year, the Minister introduced some additional measures in the area where we were not announced on Budget Day, and we live in hope for that. In this context, I want to note in particular the Legislative provisions that deal with bringing the young trained farmer stamp duty relief and the stamp duty for consolidation relief into compliance with the EU state regulations to apply to them. We know that income averaging allows elder farmers to calculate their taxable income as the average of their income in their current year and the previous four years on a rolling basis, thus modifying their taxability over a five-year cycle. We know about the weather. We saw last night, which surprised me because I live in Tipperary in the Golden Vale, and we grow a lot of good spuds, thank God, and we're able to dig them at present, but we saw the floods up in the Midlands and elsewhere, where we wouldn't expect it. So we know that that has to be for an incident like that with weather, whether it be a storm or whatever. We know the damage was done by the previous hurricanes to our horticulture industry, which is huge in South Tipperary. So we must allow this issue to balance out. It used to be the case that certain farmers were not entitled to avail of the income averaging regime as they are their spouse or their civil partner earns another income off-farm. The amendment announced by the Minister of Donoghue last year, however, extended the scheme out to such farmers, with averaging only applying in respect of farm profits, and I welcome that. The Minister will increase the number of farmers who are eligible to avail of this scheme. We need to see far more of these kinds of supports, Minister, especially in the post-Brexit scenario. I will be placing amendments on some related matters, and I have already. I've had to return to them in more detail at that time. I had a budget submission to you and Crow, Minister, and say, oh, you didn't bother, you offered no alternative. Some simple things. I said the tax on land over 750 acres. Who in God's name wants 750 acres of fertile land to make a living? Who wants it? Don't need it. 200 acres should be good enough for any, but I've gone up that high to see could I put some manners on the conglomerates that are gobbling up our land and destroying our economy and destroying, most of all, our rural villages and our way of life. Some of the measures I had asked for in my pre-budget submission included, supports for business and the self-implied. We've got a hospitality back rate of 9.5%. It was a retrograde step to change it last year. The introduction of a corking and capping tax in the sale of alcohol in supermarkets multiples. But again, I had this year in 2013 with Minister Burton. I assured me, I had with Minister Lynne and God Weston several years, pleading and begging. We know the damage it's done, the cheap and the proliferation of availability of drink to young people. And we know the problems it's causing and we know where it's been. Not the pubs. You've tried with Minister Ross to close all the pubs and you're fairly well succeeding, choking them. Not to ever mention that there were VAT payers, taxpayers, rate payers, employers, the whole lot. But you just quenched them because you were afraid he'd pull out of government and you'd lose your good jobs. The introduction of capping charge in the sale of alcohol in supermarkets, as I said, it's a no-brainer. And when that didn't happen in 2013, the Minister Burton had assured me that it was happening. She wasn't in the Minister of Finance. She said, I asked the day after, what happened, Minister? She said, unfortunately, the supermarket lobby are more powerful than the windows lobby. It's not about lobbies you shouldn't be, it is with G. It's about people's lives and the damage that over-availability of alcohol is doing. The detention and current excise duties on diesel and petrol, sorry, retention, application of the lower VAT rate on 13.5% to the entire industry. You were warned about that too, David E. Kelly, the Minister, but he wouldn't listen. The expansion of social protection payments and benefits for the self-implied, which we welcomed the staff to a sophomore and a Hebrew last year, to ensure that they are sufficiently supported during times of illness and low-income. They are the people who put their money by their mouths. They are the steepest knives trying to get paid for jobs and design jobs. And they are the employers and supporting them, they have good staff and they want to keep them on. They need to be supported when they're sick. We saw when the crash came, everybody got support except him. And he had no sympathy from a town minister. None. The introduction of a work and family payment to ensure the social welfare schemes, supporting low-income families, do not discriminate against the self-implied and farming families. Very basic human right. There is an increase of local roads funding by 25 per cent in 2019 and the extension of local approval scheme, which we have fought for in the program for government. Because our roads are kind of part in Tipperary and all over the country. The introduction of a vat relief on vatic is purchased by community and voluntary groups. And they are quite numerous. And they do great work with Meals on Wheels and collecting people to bring into hospital pines or whatever. With the examination of the vatic is applied to vital and life-saving equipment. This is a fass. Communities are collecting money for the whole lot of life-saving equipment. And most villages have two or three units now. And they pay for 21 per cent vat, 22 per cent vat. It's a disgrace. People are giving this money voluntary, money they've already paid taxes in. Working people, farmers, businesses, you name it. And they charge vat again. This is scandalous. Measures to fast-track the construction of new social and private housing. That's not going to happen, Minister. Because you have a fundamental, a fundamental belief in Fine Gael that you don't want to build houses for the people. Let them eat cake. That's easy. Let them go to hell. Look, it's proven. You have announcements after announcements after announcements. I sit on the housing committee and I'm so sorry everyone near it. We could build houses with paper and reports. We'd have mansions for everyone. You don't want to build them. It's a psychic in Fine Gael psychic. Let them go to hell. Never did. At least be informed or proudly. Ah, we'll build the houses for the ordinary people. But you won't do it. As I said, the development of the new coordinating unit within the Department of Enterprise. To work with communities. To develop opportunities to keep vital local services in place and retain and develop vibrant local economies. The living town. A scheme that's hijacked. Where you had, in course, shops and places that close down to renovate and let people come in and live in them. You do two things. You reduce the housing list, but you make it a living town. You have abandoned that again. You have minister ringing an ounce of money. For every part of, from Bohola to Nach. Every place else in Mayo. Once it's Mayo, he'll give them the money. But not a ping in the one. Tip it on. But you've been found out minister. You have been found out. And the game is up. People are waiting for you with the Pian Lewis. Inside in the little box. And there'll be no double vote. Not calling for six votes. Or someone else not in a wink vote for me. One by one. They're going to cast their cold eye inside the privacy of the ballot box. Not a way all you like. You'd be nothing like Danny Hilliway. No. I'm just saying. They're waiting in a long grass for you. And why wouldn't they? Because you'd never had any interest in the little people in Dina Boga. Never in Finnegale. And they think that you're supported and kept in power by the lads here beside me. It's a shocking state of affairs. We have no opposition to the ghost. But look. You'll be found out. And you are found out. And the people going to privacy of the boxes. I said. They will. Get rid of the posh pies. And T-shirt. The minister for housing. The posh pies. Minister Harris. I'd been mentioned to the Children's Hospital. And the scandal. That no grand child of mine had one new one bought. Young Cahill. Last Sunday night. I would welcome him into our family. And delighted at the life that he's living. And well. And they'll never get into that hospital. It's the biggest tragedy. And travesty that ever you perpetrated. Under your watch. And it's going on and going on. And the hole is getting bigger and bigger. And you're lucky. If you won't be all fine deciding. And bulldozed over. And forgotten about. And just. You'll be bad taught in people's memories. Nothing else. Because you don't deserve any good taught. Because you don't. You don't. You don't respect the elector. And the mandate you got. You think you can bulldoze too. And I'm surprised that. These lights here give you the nod. Every so often. Under the umbrella of Brexit. I don't know what's going to happen. If Brexit gets solved. The whole act will fall down. And there'll be a big bust. A rupture in the pipe. The water. The confidence of the supply. It'll blow up. And blow out to the dome. And it'll go here. Because that's what's going to go. Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going? Where am I going?