David Cullinane
Waterford · Sinn Féin · Ireland
“I met many of those patients and people with the illness yesterday. Many of them were here in Leinster House. They told me, as they have in the past, they cannot walk and they cannot swallow and, as the Taoiseach acknowledged, it is also very difficult for their families who have to watch as their condition worsens and the disease progres…”
“In fact, in the programme for Government the Government committed to reviewing that process because it was accepted it does not always work. The technical review group obviously now needs to be convened and needs to meet urgently. Emily cannot afford more delays.”
“Yesterday, as the Taoiseach knows, the HSE drugs group met to consider reimbursement of Skyclarys, the first approved treatment that can slow the progression of Friedreich's ataxia. Patients hoped for a positive decision. This process has been ongoing for years.”
“They were left desperately making phone calls, checking for updates, asking journalists and asking politicians if they had heard anything. They were treated appallingly. Then, when the news did eventually filter though, they were left devastated.”
“Richard Walsh, consultant neurologist and co-director of the National Ataxia Clinic, has described this drug as a ground-breaking development. He has said that he would prescribe it if it were available in Ireland and that it may reduce the rate of disease progression.”
“"We are not going to regain any of the abilities we've lost, but Skyclarys will give us time. Time when you're dealing with our progressive relentless disease is everything. We all deserve time with our loved ones." Those are the words of Emily Felix, a 28-year-old trainee solicitor from Kilkenny who is living with Friedreich's ataxia.”
The complete record
Every one of 786 lines we hold for David Cullinane, in date order, each linked to its source. Free to read, in full, without an account. Page 7 of 16.
“Infrastructure development is really important and is obviously important for every city, county and constituency, so I wish to raise infrastructure development for Waterford city and county and the wider south east. The North Quays development has received significant Government funding so I want to start by acknowledging that. However, I also have to say to the Minister that, per capita , the south east and Waterford are not getting their fair share and have not been getting their fair share of capital funding for a long number of years. Even over the past year, I have raised so many different issues. I will start with the N24 Waterford to Limerick road. What is really disheartening about that project is it is not a great road. I know a lot of people who use it every day. It is very dangerous and needs to be upgraded.”
“The council is telling me that this year, it still has not received its allocation. I ask the Taoiseach to look at this issue again because this scheme is one of the few supports that is available and is actually working for those families.”
“The senior management in the council told me that the best way they can describe the Government's response to this issue is that it turned the funding down to a trickle. In 2023, the council was able to purchase 29 homes in Waterford under the tenant in situ scheme. In 2024, it was 39 homes, but because the Government dramatically reduced the funding last year, it was four homes.”
“The Taoiseach says time and again that housing is the number one issue for this Government, and he accepts that there is a housing crisis. Notices to quit are on the increase in every county, including mine, Waterford. Last week, I met with three families, all of which have children, who received notices to quit. They are very worried and stressed about having to find alternative accommodation, which the Taoiseach knows is not easy. They have been getting on to letting agencies and asking me and others to support them. It is a really stressful situation. Obviously, I contacted the local council to see what support it can give, and one of the few options was the tenant in situ scheme.”
“That is very often not the case and it is unacceptable that, as a result, far too many people end up in emergency departments, where staff are dealing with the chaos that arises when people are on trolleys and so on. This is not the best place for people to end up. We need to make sure we have community services in place. When people do go to emergency departments, there should be dedicated spaces available and the best supports should be given to those who need help and support.”
“Nationally, every year, tens of thousands of people present to emergency departments in a mental health crisis, including experiencing suicidal ideation and severe mental distress. The Mental Health Commission has found that international best practice is not available in most emergency departments. The commission also found wide variation in quality across the State and that eight emergency departments did not have appropriate spaces for mental health crisis assessments. That exposes people to chaotic and unsafe environments. This motion is about making sure emergency departments are equipped to deal with somebody who has an acute mental health episode. We also need to make sure services are provided at community level as well.”
“In Waterford hospital, in the constituency the Minister of State, Deputy Butler, and I share, which has one of the best performing emergency departments in the State, there is a dedicated room made available, which I welcome, but specialist staff are mostly only rostered during normal business hours. The psychiatry department is not fully staffed and out-of-hours care can be reliant on on-call specialists who are off-site. There are just two full-time specialist nursing posts for the suicide crisis assessment programme working out of Waterford, when at least five full-time posts are needed to provide 24-7 cover for the south east. That is replicated across the State.”
“This is a resourcing problem and, I have to say, a political problem. Every acute hospital should have a separate mental health crisis room. Every emergency department should have a full complement of psychiatrists, specialist mental health nurses and allied care staff. They should be working with a full complement of suicide crisis assessment nurses, linked in with GPs, to provide an alternative to chaotic emergency departments. When suicide crisis assessment nurse, SCAN, services are understaffed, it piles more pressure on emergency departments and leaves no alternative for a person in crisis.”
“I second the motion because emergency mental health care services are not fit for purpose. Too many people in acute distress feel they have little choice but to present to chaotic and overcrowded emergency departments that are simply not designed to meet their needs. This motion is about fixing and reforming the system, not managing its failures. Specialist care and safe spaces, such as assessment rooms, should be available 24-7, so that no person in an acute mental health crisis is left without care or left waiting in a chaotic emergency department room, as far too many people are. However, far too often, these services are only available from 8 a.m. to 5 p.m. but, as we know, a crisis does not wait for normal business hours. This is no reflection on the staff in our emergency departments who do Trojan work.”
“I imagine there is even push-back against this from some of the private providers. The role of the State and the role of the Government is to make sure we can deliver on this. It is the job of the Minister of State and the Government to deliver on the promises made in this area. I do not believe the Government will be able to do it unless it builds public capacity. It has not built up public capacity which is why year after year it comes with Bills like this as opposed to a statutory home care scheme. It is simply not equipped or in a position to deliver it.”
“We are paying premiums to private providers to provide services that should be provided through the public system, given that we have all signed up to the principle of a universal healthcare system, public healthcare and Sláintecare. This is what we have all signed up to but what I see is more and more privatisation and systems dependent on the private sector. We see it with dentistry. We have more private dentists than public dentists. We have more private nursing homes than public nursing homes. We have more private home care providers than we have public providers. This is wrong and we need to rebalance the scales. We need to invest in the public service. We are not going to be able to roll out a statutory home care scheme unless we have public infrastructure.”
“I want to make a point on something I am concerned about generally in healthcare. When we are speaking about home care we have to accept that because of decades of a lack of investment in public home care, the vast majority of providers are now private. We have also seen this with nursing homes. At one point a majority of nursing homes were public but they are now private. The majority of home care is now being provided by private providers. I am not casting aspersions on the private providers, and the staff and the people do a good job, but we need to build up public capacity and we need to make sure we are getting value for money and bang for buck.”
“I imagine that most people probably thought this was already in place. That is something that is really basic. Of course all home care support services should be registered, of course they should be subject to regulation, and of course HIQA has to have the powers to look at these areas. For most people this is a no-brainer and they would have expected it to have been in place. The fact we are only dealing with this now is problematic, and we still do not have the statutory home care scheme, as I said. I ask the Minister of State to examine the difficulties in the north west. It is an issue that an Teachta Doherty in particular has raised with me. I have spoken to the head of the HSE on this and he has acknowledged that there is an issue, which is a staffing issue.”
“We have seen it in so many areas of healthcare. Beds that were promised were not delivered. Staff that were promised were not delivered. Pharmacy agreements that were promised were not delivered. The Government made these big announcements and then left people high and dry. That is what was done with the statutory home care scheme. What is really frustrating is that despite two programmes for Government that promised a statutory home care scheme, and all of the years that have gone by, the best the Government has done is to say it will regulate the area, have a registry and make sure service providers are registered. That is great but it should have been done years ago. That it is taken so long for even this Bill to be brought forward, given the commitments we were given, is staggering.”
“Huge advances have been made where a person does not necessarily have to be in hospital to get certain care. Some people do, but there are categories of patients who can be cared for at home. The problem is that we cannot realise that potential because we do not have the capacity. What happens is that it is a postcode lottery, patients go on a waiting list, and they may or may not get the home care supports that they need. That is not what should be in place. That is not where we need to be. I have seen it far too often in healthcare, particularly under the previous Minister for Health and indeed, the current Government as well. Big promises are made that we are going to do all these wonderful things with Sláintecare being the biggest one. It was the big vision for healthcare, but then we do not see the practical delivery of it.”
“Their families want them at home. It is the best place for them. They can care for them to a level, but they need additional supports to discharge them. They have additional needs, and they cannot get the supports. They are pleading with the hospital and community services. Sometimes there is not joined -p thinking between all those services but for the most part, the capacity is not there and the person cannot be discharged. If a person cannot get care at home, he or she ends up in hospital. There are major advances in health care. I am a member of the Joint Committee on Health, as is the Cathaoirleach Gníomhach. We are learning all the time of the advances in technology. For example, we hear about virtual beds, the principle of which is great. A person could be cared for and monitored, including their blood pressure, from home.”
“It is saying, "Hang on a second here", or maybe it is coming from the Department saying, "Let us be very careful about statutory schemes because that places an obligation on the State." However, the reality is that this is badly needed for many families. Everybody has the right to the best available care. A long time ago - well before Sláintecare - it was an accepted principle in the health care system that if it is appropriate for a person to be cared for at home that is where they should be. We have far too many people in hospital who should be at home, but they cannot be discharged from hospital because the home care supports are not available. I deal with this all the time as the health spokesperson for my party. I get queries in from all over the State relating to people who are in hospital and want to be discharged to their homes.”
“It reminds me a bit of the Disability Act 2005 where the Government of the day decided rightly that we would confer a legal right for a child to access an assessment of need and that that assessment of would look at the health and education needs of each child. On the basis of the aggregate assessment of need carried out, the Department would then be able to plan and provide the appropriate resources, including speech and language therapists, occupational therapists, psychologists and so on. That never happened. Of course, what has happened is that people are waiting, waiting and waiting. Parents are taking the State to court. I have a concern that is what is holding back the Government on this.”
“Some get partial hours, which is not all the hours that they need. Others do not get any at all and are stuck on waiting lists. Two of my colleagues in Donegal, Deputies Doherty and Mac Lochlainn, have alerted me to serious problems in the county in accessing intensive home care packages. There is a long waiting list. We have patients and families who need urgent support at home, and they cannot get it. I suspect that is what happening here. Statutory home care is a game-changer. It means that there will be a statutory right or a statutory obligation for a person to have access to home care. That will place more of a burden and obligation on the State to provide that care. The Government, HSE and Department are not equipped to deliver it.”
“Not only is there a commitment to a statutory home care scheme in the programme for Government, but it was included in the previous programme for Government, . This was to operate on a similar basis to the fair deal scheme. We still have no details of how that will work. We still have no details of who will be entitled to it or who qualify, what equity issues will be in play and when this will see the light of day. I suspect that we have not seen a statutory home care scheme in place or any movement on this issue because we do not have the capacity to deliver it. The Government should be straight and upfront with people. We know and all deal every day in our constituency offices with families who are waiting for home care or intensive home care packages. Some families and some people get them.”
“It brings the framework for home support providers into line with the model used for designated centres, HIQA standards and an expanded role for the chief inspector, all of which I agree with. It provides for a public register of providers, including key details and conditions of registration, a prohibition on operating without registration with offences and penalties, inspection and enforcement powers, including compliance notices and court applications where serious risk is identified, data collection and publication in aggregate forum ensuring that we can finally see what is happening in the sector. In plain language, this is about regulating providers, but it is not about delivering entitlements for patients.”
“I have ten minutes, and I am sharing time with two of my colleagues. I welcome the opportunity to contribute. We will support the Bill on Second Stage because the private homes support sector must be regulated, and families deserve basic assurances of safety standards and accountability. However, supporting a Bill is the not the same, as I am sure the Minister of State will agree, as applauding the Government's record, which I wish to turn to. This legislation is necessary, but it is also a stark admission of how little has been delivered and how low the Government's ambition has fallen. The Bill's purpose is to amend the Health Act to create a statutory regulatory framework for registration, minimum standards, inspection, enforcement and data collection for home support providers.”
“The council has supplied extensive evidence to Uisce Éireann but gaps in monitoring – which, again, is no fault of the people who live in the village - and a lack of proactive assessment appear to be preventing Bunmahon from being fairly considered for investment. The reality is this: communities like Bunmahon are being held back not because there is no need but because there is no action. When there are deficits in water infrastructure, homes cannot be built, businesses cannot expand and environmental protections are compromised due to what is chronic under investment. I am asking the Minister to examine this issue and, if he can, to come back to me in writing because I have to say any of the responses I have got from Uisce Éireann, as scant as they are, have been wholly inadequate.”
“Bunmahon is a growing coastal village, a vital local amenity and an important tourist destination yet its wastewater system is wholly inadequate. During winter months, the network regularly surcharges creating pollution risks, threatening public health and damaging the local environment. This is not a new issue. It is long standing, well documented and has been repeatedly raised by Councillor Catherine Burke, a Sinn Féin councillor, but also by Waterford City and County Council itself in email correspondence and letters to Uisce Éireann. Despite this, Bunmahon is again being excluded from Uisce Éireann's small towns and villages growth programme. That decision is deeply disappointing and unacceptable.”
“I want to agree with Deputy Mac Lochlainn. We all have very similar problems with Uisce Éireann. We are on the front line of dealing with these issues. Communities come to us because they have no way themselves of getting through to Uisce Éireann. They expect that their democratically elected public representatives can get fast information for them. Through no fault of our own – because we try – we cannot. Deputy Mac Lochlainn is right. We send the emails, we get a reply and very often the reply is inadequate but it can take days to come. I want to raise serious concerns regarding the continued failure of Uisce Éireann to address wastewater infrastructure deficits in small coastal rural communities, specifically the village of Bunmahon in County Waterford.”
“I would, however, caution the Government and the Minister of State by saying that we must watch out because the industry is already trying to get ahead of this. It is looking at laws such as this and finding ways around them. That is unacceptable. We must ensure that laws can be changed quickly if they need to be, by way of amendments, to ensure that we stay ahead of any attempt to circumvent the intent of this Bill and do not fall behind.”
“My primary concern in relation to everything we do is protecting children and ensuring that by way of controlling sales, advertising, flavouring and packaging, we do everything possible to limit the ability of the industry to target children in the very obvious way it does. Any measures or Parts of a Bill that come before me and do that will have my full support and that of my party. I have, as I said, a concern about the lack of consistency from the Government and its lack of coherence. This is the third Bill, as I understand it, in the past three years. We are expecting at least one more Bill and possibly another. There is at least one more Bill coming. It is not the most coherent way to deal with a matter as substantial as this. I will be supporting this Bill because it is clear and simple in what it does.”
“I think that if somebody who was smoking long term switched to vaping, it would be a better option. I would obviously want a person to neither smoke nor use a vape. That is the ideal scenario. However, we must be grown up and accept that people smoke and use vapes. We must ensure that we take a balanced approach. I do not believe that banning every other flavour and moving to a tobacco-flavoured option is a balanced approach. It could create more problems. I know from talking to people who vape that they would see that approach as over the top and a typical reaction whereby we rush to ban everything rather than listening to people who vape.”
“We must protect children and limit the impact that vaping has on them. I know, and everybody else in the House knows, that the industry is cleverly targeting coloured and flavoured vapes and packaging at children. This has been going on for far too long. Obviously, bans on advertising are part of the solution. We need to limit flavours. However, I think there is a rush in this House too often to ban everything and not to consider a more balanced approach. I have spoken to many vapers over the course of the past number of years, and particularly in recent months as Bills such as this have come before us. I know there are different opinions as to whether vaping is a step down from smoking and whether it is something that is a good aid to act as a replacement for smoking.”
“I was a member of the Oireachtas health committee when the original Bill on vaping came before it. We raised issues about single-use vapes, flavouring, advertising and other issues. No such measures were included in the Bill that was before us at the time. We were told that a parallel Bill was being worked on. Ever since, the legislation has not been satisfactory and we have seen the piecemeal approach. All the while, the industry is watching and trying to get ahead of the Government, which is not too difficult, given its piecemeal approach. We in the Oireachtas need to ensure we are setting regulations in a timely manner, are ahead of the industry and are not always falling behind and playing catch-up. I make that point because it is a reality from my perspective and needs to be said.”
“The Bill proposes to ban single-use vapes and creates a framework to achieve this. The ban will be in effect within six months of the commencement of section 7 of the Act, as the Minister said. I support this Bill because it is simple in what it seeks to achieve, which is to ban single-use vapes. I will offer my opinion on, and a critique of, the Government's wider approach to this issue. I will first talk about single-use vapes. We are already seeing the industry attempting to get around these measures. We have seen that in Britain where vapes have become rechargeable, even though they are still single use. There are at all times attempts by industry to circumvent the Act. This is the problem. We have a Government that has never got ahead of this problem and has taken a piecemeal approach.”
“It is not good enough, by the way, that the Government will say it is not opposing the motion but will then not do anything about it. It has to go and negotiate with pharmacists and put in place a long-term solution for those people it has abandoned.”
“We all signed up to the spirit and logic of Sláintecare, where we want a transition to a single-tier health service that is free at the point of delivery. I hope that is where we are going. We have had a couple of examples over the past number of weeks and months, where I have had to seriously ask myself whether this Government is committed to that. It is not unreasonable to ask a Government, in circumstances where vulnerable patients are now being left high and dry, to do its job. As was said, the Government knew when it negotiated this agreement and, as it saw it, tightened up on the rules in relation to phased dispensing, that this was going to happen. I knew it was going to happen. I warned the Government, it did not listen and now we have very upset, vulnerable patients who have been left high and dry. It is simply not good enough.”
“I have no problem with transparency when it comes to the Minister, the Government or pharmacists. I have no problem with what the Minister called "targeted probity processes" being put in place to examine what pharmacists were or were not doing. That is a matter for the Government, the regulator and pharmacists, but what was missing entirely from the Minister's opening speech was any empathy for people who are now left high and dry. That was what was missing - that human empathy where very vulnerable patients are now being told they are going to have to pay. What I am saying, and I do not understand why this would be in any way a mystery to the Government or seen in any way as radical, is the State should pay for those vulnerable patients.”
“I will clear a number of things up for the Minister, who is not here, because she seems to think we do not understand how this works or what issues are at play here. We have never said that every patient has had blister packs paid for. That was never the case. We also understand, and I acknowledged this at the time the community pharmacy agreement was being reached, that phased dispensing was being used by some pharmacists to offset the cost of blister packs. Whatever about the rights and wrongs of that, which is what I said to the Minister in my opening remarks, what is undeniable is vulnerable patients are now being told they will have to pay. Whatever about the indirect or unorthodox way it was paid for in the past, that does not really matter to those patients right now. That is where the Government and the Minister are tone deaf.”
“The only thing that matters for them and their families is that they are now facing an additional cost, and that is very unfair on those patients.”
“We are being constructive in tabling this motion to ask the Minister to engage and to look at putting in place a scheme whereby this can be funded. There are different ways this can be done. She could allow GPs, for example, to determine whether, through the same funding pot as phased dispensing, we provide for blister packs as well. Obviously, funding into the pot could be increased. There are a lot of options open to the Minister. However, the option of saying "No" will not win over the support of those people who are now, as they see it, being left high and dry. I know the Minister is not opposing the motion but I appeal to her to listen not just to me but to all those people who have reacted very angrily. They do not really care who is right or who is wrong as to how these were funded in the past.”
“I do not understand this approach. It may not have been the Minister who gave the speech in the Seanad but certainly it was a Minister who essentially doubled down. Nowhere did the reply say there would be any agreement. In fact, what it said was that this is a private matter between patients and pharmacists. I understand that this was funded indirectly; I said so at the time. It seems that this was funded through the phased dispensing scheme and that pharmacists were essentially offsetting the cost of blister packs through phased dispensing. Whatever about the rights and wrongs of that at this point in time, many of these people who were previously getting it funded now have to pay and they simply cannot afford to do so.”
“The Minister issued a statement on Friday of last week saying that she would put on hold the new community pharmacy agreement for a couple of months. The reason she gave for putting it on hold was rightly, that there is a lot of additional work for pharmacists. They are administering the flu vaccine and the Covid vaccine, which I got myself in a pharmacy last week. There is obviously additional work in managing diseases and the flu circulating in the community and other issues that pharmacists are dealing with. That was the reason the Minister gave. Nowhere in the press statement did she say she would look at this. In fact, she described blister packs as being private fees. In a response she gave in the Seanad, she doubled down as well on that.”
“However, it was not a shock to me that this was going to happen because I raised it directly with the Minister. I also issued a press statement at the time when the new community pharmacy agreement was put in place. I recognised this as a glaring omission and I warned that this would become an issue and unfortunately, it did. I understood the importance of them for patients and families and I certainly knew that when the time came and people realised that what they were getting previously free of charge and covered was going to be to be subject to a charge, would go down very badly and rightly so. It has been described as cruel by many people who have texted into radio programmes over the past week as well.”
“I know from my own siblings and others who look after people that they have to make sure that the blister pack is out, the patient uses the appropriate medication and everybody benefits from it. It is really good for patients and there was an awful shock, when patients received notification formally or informally that this was going to come to an end and they will have to have to pay for it. Sometimes we lose sight of the fact that €20, €40 or €50 a month is a huge amount for some people. We cannot ever live in a bubble here in Leinster House. We have to understand that this type of charge is a loss for a person who is on a very low income, a disability payment or a low-paid pension. For those people to be hit with this additional charge really did come as a shock to them and their families and to carers.”
“It came as a shock to many patients when they received letters from pharmacists or were told orally by pharmacists that the blister packs that were previously funded and paid for, as they saw it, were now going to be subject to a charge from 1 January 2026 onwards. It is important to point out that these are very vulnerable patients. The vast majority of them are older people, over the age of 65. They are people with dementia, disabilities and a range of health needs, but they are the most vulnerable patients. The vast majority of people will not need blister packs, but for those who do, they are a necessity and they are important for a number of purposes. They help patients manage medicines, and they are also a very important aid and tool for carers and family members.”
“I move: That Dáil Éireann: notes that: — in September, the Government accepted and published the new Community Pharmacy Agreement 2025, which was negotiated by the Department of Health; — the Community Pharmacy Agreement 2025 explicitly excluded reimbursement for monitored dosage systems (MDS), which had previously been reimbursed through the phased dispensing reimbursement mechanism, a practice which was widely known, accepted, and unchallenged by the Government; — MDS, such as blister packs, are an essential and basic tool for improving medication management and safety, and can be the difference between taking medicines safely and risking missed doses, double dosing, or dangerous confusion; and — the Community Pharmacy Agreement 2025 could have included reimbursement for MDS where they are requested by a person's general practitioner or other appropriately qualified treating clinician; further notes that: — blister packs without subsidisation can cost an individual in the range of €20 to €50 a month, even more in some cases where a person has particularly complex needs; — blister packs are an essential component in medication management, which allow for greater involvement of a person's carer or personal assistant in ensuring a person receives the right medicine in the right dosage at the right time, particularly where a person has cognitive or mobility issues or a physical or intellectual disability, which is otherwise not permitted; and — many people, in particular older people, people with disabilities, and people with multiple conditions, had come to rely on this service being provided free of charge and cannot afford the additional cost which the Government has now imposed on them, which can accumulate to several weeks' worth of income a year; considers that the inclusion of MDS in reimbursement arrangements with pharmacies is a small step towards universal healthcare which the Government should take; and condemns: — the Government's decision to withdraw blister pack supports from vulnerable people at the most expensive time of year for households and in the midst of a cost-of-living crisis; and — the failure of Government and the Minister for Health to ensure coverage of MDS in the new Community Pharmacy Agreement 2025 on the basis of need; and calls on the Government to: — urgently avert the new fees for MDS, which are due to take effect from 1st January, 2026 by temporarily permitting reimbursement as was the case to date; and — immediately engage with the Irish Pharmacy Union, to include a reimbursement mechanism for MDS in the Community Pharmacy Agreement 2025, which delivers coverage on the basis of need, not ability to pay for all people who need them on the basis of a clinical recommendation.”
“We also remain committed to people getting timely, fast and rapid access to care, as best we can. This will not happen overnight and there is a lot to be done to get to a point where we can reach those targets. Unless we take targets seriously, however, which the Government is not doing based on the Minister of State's speech, and use those targets to mobilise and marshal the resources of the health service to meet them, patients will continue to wait. I gave the examples of patients waiting for cataract, hip and hernia operations, which are standard day-case procedures in most cases, but there are others, including cancer care, cardiac care and so on. I am disappointed the Minister of State is not accepting this Bill. I will take this up with the Minister for Health.”
“However, simply to say we are not doing it because we do not believe we can do it to the same standard as acute hospital waiting lists is not a satisfactory response. We have an entitlement to the highest levels of transparency. I imagine it frustrates patients that we spend tens of billions every year on health and yet there is basic information we cannot collate or publish. I will finish how I started. If I was in the Minister of State's shoes, I would have handed the speech back and said, "No thanks, I am not going to read that out" because it essentially tells the public the Government is again walking away from one of the key proposals and action points it had in accepting Sláintecare. That is regrettable. My party remains committed to Sláintecare and to the highest levels of transparency in the health service for waiting lists.”
“It is really saying it cannot publish the community waiting list times through the NTPF, in the same way as the acute hospitals, because we are not up to that standard yet. What an appalling response and appalling situation for us to find ourselves in. We have children and adults on those waiting lists waiting for access to dentists, dietitians, speech and language therapists and all the other community waiting lists. We get those responses back through parliamentary questions. They may not be perfect, and I made that point earlier, but at least we get numbers. It is possible for Government to publish those waiting list times. If they are imperfect and need to be improved or brought up to a standard similar to those for the acute hospitals, that can happen over time and evolve.”
“The purpose of setting a maximum wait time was to force the system to put the capacity in to meeting that objective. The Government is now walking away from that. The Minister of State shook his head earlier when he indicated it was not but clearly it is. The reason he gave for opposing this Bill was that the Government did not have to accept this because it was doing it anyway. It is not doing it. It does not have statutory targets. I do not know if the Minister of State could point to me where on the Statute Book the Government has ever legislated for the Sláintecare targets. I know it has not done so. Coming then to the community waiting lists, I find the Government's response on those even worse, and breathtaking in many ways. It is an acceptance of utter failure by the Government.”
“However, if we set it as a target, the entire system - the staff, consultants, nurses, healthcare assistants, radiographers and everybody working in hospitals and in other parts of the healthcare system which are crucial in the context of reducing crises in emergency departments and identifying what the capacity needs are - will be forced to get us to a point where we do not have patients on trolleys. That is precisely what happened and it would not have happened if a zero-tolerance approach had not been taken. It is the same with the maximum wait time targets. The reason Sláintecare set those targets was that it was believed, on the advice of the Department, the HSE and all the experts who came before the special Oireachtas committee that looked at Sláintecare, it was possible to do it.”
“In the context of Sláintecare, it is understood that process is important. Setting targets is also important, however. I do not believe we will ever solve the problem in emergency departments and have a situation where people will not be left on trolleys if we do not adopt a zero-tolerance approach. That is precisely what happened in Waterford, where the hospital manager at the time said that one person on a hospital trolley was one too many and adopted a zero-tolerance approach as a result. He did not believe change would happen overnight, or in a week or a month.”
“It is a case of "We will see what is going to happen, but we are not going to do anything and do not really care." That is what I hear from Government. Before I get into some of the process issues behind the Bill and the reasons I think the explanations the Minister of State gave are utter nonsense, I highlight the fact that I am also of the view that we will not reduce waiting lists until we put capacity into the system. We have to build the four elective hospitals. We have to deliver on the hospital beds. We have to deliver on the diagnostic capacity. We have to upgrade equipment. We need new equipment in some hospitals, and we need staff. We need to train more healthcare professionals to fill the gaps where there are staff shortages. All of those are obvious ingredients when it comes to reducing waiting lists and providing faster care.”