Mattie McGrath (Tipperary, Independent) | Oireachtas source

Níl aon Healy-Rae anseo so tógfaidh mé an t-am go léir, or I will do my best to anyway. Tá siad i gContae Chiarraí. I am delighted to speak on this Bill. The rent a room scheme, which the Bill tries to enable or help, is a very imaginative scheme. It has been a success but there are unintended consequences to every scheme and provision we make. The scheme should be expanded to ensure people are not disallowed medical cards as a result of exceeding the income threshold. As we know, the scheme is a tax-free initiative. The Bill needs to understand that. The medical card rates are difficult to traverse anyway. It can be very harsh for people who get an increase or some other form of income that puts them barely over the threshold, making it difficult to obtain a medical card. The medical card is worth a great deal to many people. The peace of mind it offers is probably the biggest thing. They know they can get the prescribed medication they need without facing enormous costs. I welcome the changes to be brought about in that regard.

Staying within the scope of the Bill and with the permission of the Cathaoirleach Gníomhach, as the Minister of State, Deputy Butler, is here, I will ask her about St. Brigid's Hospital in Carrick-on-Suir.

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It was closed during Covid. First of all it was seconded for Covid and then it was not used for Covid in the middle of it all. It is not reopened to inpatients in spite of the fact that the Minister for Health, Deputy Donnelly, assured Councillor Kieran Bourke of Carrick-on-Suir and Deputy Cahill that it would be returned to use as a hospital. This is a much-loved hospital. I was down there at a rally on St. Brigid's Day, hence the name St. Brigid's Hospital. The three hospice suites have disappeared and we have not had the other step-down facilities. It came before the petitions committee and they looked at it and examined it but there has not been any progress. We had a meeting with an official from the HSE whose name eludes me now. He was the only person who came and looked at the hospital. He said he was doing a detailed examination and he would report back to the people in Carrick-on-Suir and to the subcommittee there. It is very important because this hospital is such a lifeline, and especially now there are such problems in University Hospital Limerick, UHL. There is also pressure on South Tipperary General Hospital and University Hospital Waterford because the step-down facilities are not as available as they were.

There is a lot of dysfunction in the HSE. The Minister of State, Deputy Butler, is aware of this. I heard the Minister, Deputy Donnelly, say last night that he had directed officials to change a decision they had made recently. That is his job and that is what he should do. A new nursing home, St. Conlon's in Nenagh, is finished but it has not opened as there are no staff. Surely when we were deciding this, building it, kitting it out and so on - I am told it is in pristine condition - it would have been anticipated that staff would be needed. Where is the joined-up thinking? They have a state-of-the-art building now, at a huge cost, but it is not available because no staff have been recruited for it. It is the same across many areas. This situation is untenable, especially given the pressures on UHL.

As part of the amalgamation within the UHL hospitals group - they called it a "reconfiguration" - accident and emergency departments were closed in Nenagh, St. John's and Ennis hospitals. We were supposed to have so many beds in UHL but the number of beds we were promised has never materialised while the population has grown. There was a set ratio of beds per head of population but this has been vastly exceeded. There is complete and absolute bedlam there as we speak. Last week was horrific because 150 people were waiting on trolleys in corridors on one day. This is unsustainable. While we feel for every person on a trolley or a chair with the bedlam in the corridors, we must also feel for the staff with the fatigue and the stress. The inhumanity of it all being allowed to go on is shocking. We have been told by the Minister for Health that the trolley numbers are falling. They certainly are not falling in our region. The numbers beggar belief. A lot of it has to be down to bad management. The management must be held accountable. They are unable to manage. We must question the employment of some of these managers, and what experience they have. Is it a case of who you know and not what you know? It is shocking that this can be allowed to happen.

This morning I raised a mental health issue that I believe comes under the area of the Minister of State, Deputy Butler, or that of the Minister of State, Deputy Rabbitte. Many people are languishing on CAMHS waiting lists, and many young people are forced to be incarcerated in adult psychiatric institutions. It is unbelievable. I cannot understand how we can accept that. The figures are plain to see. We saw what happened with CAMHS in south Kerry. There is also a shocking situation in our area of south Tipperary. Reports have been commissioned that have called it out. The HSE has been given a D or an E mark, which is pretty bad, not an A, a B or a C. How could it have been given a higher a mark because of the situation regarding young children being incarcerated?

Can we also consider the new children's hospital? That situation is unthinkable. First of all, it was the wrong site. It is now a costly mistake. I refer to experts such as the late Jonathan Irwin, who was so passionate in the Jack and Jill Foundation. Fuair sé bás cúpla mí ó shin. I want to pay a warm tribute to Mr. Irwin for the sterling work he did alongside his wife, former Senator Mary Ann O'Brien. They did great work with the Jack and Jill Foundation and its nurses. Mr. Irwin came to the Oireachtas Joint Committee on Health with Dr. Finn Breathnach, Ms Aisling McNiffe, Dr. Jimmy Sheehan and others who had built hospitals. They had built the Beacon and Blackrock hospitals and the Connolly clinical hospital and had experience and expertise. I organised a group and a briefing in the audiovisual room in Leinster House to talk to Senators and Deputies, all of whom were invited. A big crowd of up to 70 people came, which was one of the biggest groups ever, and the speakers laid it bare. Former Deputy Mick Wallace asked the speakers to set out, notwithstanding all the talk, how long it would take to build the hospital if they had a site on the M50 and how much it would cost. Dúirt an Dr. Ó Síocháin, Dr. Jimmy Sheehan, that if he got the site with planning, if it was cordoned off and if they were left to go about their business with ease of access and everything else, they would build it in 11 to 13 months and it would cost between €900 million and €1.1 billion. The project is now well over €2 billion and growing, and no sign of the hospital. Mick Wallace is gone out of here a long time. He is in Brussels now this long time. There has been sheer mismanagement and sheer bad contracting. Former Deputy Wallace understood contracting as he was used to dealing with it as a construction person. It was a dual-model contract. I remember at the time that BAM International expressed fears that BAM Ireland had gone in way too low. BAM Ireland has a habit of doing this. They go in at an all-time low and the morning after they get the contract, they send in forensic solicitors and forensic quantity surveyors and extras. Indeed there are also unquantifiable claims in there for the hospital. If it is finished, these will go on. There is a trick of the loop going on. The final costs were announced recently and the costs of those claims were not dealt with at all. It is a no-man's land because it is down to the courts, arbitration, cases and everything else. When I visited the site with my colleagues in the Rural Independent Group two or three years ago, we saw where the neighbouring houses' backyards were falling into the hospital. This is an appalling vista.

Dr. Sheehan also said at that time that his group's proposal would provide three helipads, if necessary, outside on a flat level site. There is no such helipad on this hospital. I believe there is one small helipad on a third floor at the side of the building. Think about that when children are trying to get therapy and recover inside with the noise of a helicopter landing. I have been told the windows are of such a massive standard that they will not hear the noise.

We have huge issues with the lack of accountability and lack of proper contracts and expertise in dealing with it. I am tired of repeating this. I was told by Bertie Ahern and Brian Cowen on different occasions when each was Taoiseach that they were going to disband the HSE, but it has continued. Deputy Catherine Connolly is in the Chamber. She is forever raising the situation in Galway. We are all raising such situations all over the country. It is bad management. When I joined here after the election - I am thankful to have been elected - I believed the budget for the new hospital was to be €750 million. Now it is more than €2 billion and growing, and we are getting less accountability.

There are lots of good things going on. As I said, people get lots of treatments, but there is mismanagement in other areas. There is sheer waste, which we also saw during Covid with the waste of money on buying excess equipment, poor standard equipment, and sometimes duplicate equipment for some of the stuff they got in to deal with Covid measures. It was a waste of time. I got emails from a doctor in the west of Ireland begging me to ask the HSE to stop sending lots of couriers with this stuff to him. He had a garage full of it, as well as what was at his practice, but it kept coming. Contracts are fired out and there is no accountability, yet we can see some people waiting for a wheelchair for several months. Deputy Verona Murphy brought a buachaill óg up here from Loch Garman some time ago. The Minister of State, Deputy Butler, may have met him out on the plinth. That little boy had outgrown his wheelchair and had to come up here to make his case to get such a simple thing as a wheelchair.

There was a group of young and not so young people in the Chamber Déardaoin or Dé Céadaoin last week. Bhí siad sa Ghailearaí. Scoliosis sufferers had to come here to make their case outside the gates and come in to the Gallery. We had a debate on it. There was a vote on it last night and the Government won that vote. They suffer on. We have the EU cross-border directive scheme. It works both ways. We are doing operations here in our hospitals that are paid for by the countries that send people here. We get access to hospitals abroad. Deputy Michael Collins and others are sending busloads to Belfast for all kinds. I sent them myself for hips, knees and cataracts. It beggars belief. It is a simple cataract operation. Our volunteer doctors and surgeons go out to field camps in Third World countries to perform these operations for people and we have people here languishing on waiting lists for four or five years and they have to go to Belfast to get it done or go abroad. Why have we no bit of humanity so that scoliosis patients do not have this suffering? Why can they not be sent abroad for these operations? I know it is difficult for them to travel but at least they should be examined and that should be explored.

Last week I mentioned the case of Clodagh from Fethard, who had a little child, Keri, born with severe difficulties. She was injured at birth. That child lived to be 16 years of age. Her mother fought a battle with the HSE all the way along. When the child developed scoliosis, she was refused permission to go abroad for treatment after the operation that had been carried out was a misfit and did not work. It happens with a lot of operations. The children grow and the steel tube that is put in is no longer suitable.

I heard this morning on the radio that Dr. Tony Holohan, who was before us all and in everyone's kitchen during Covid, has been appointed to some cancer research group with a salary of €220,000. I only heard this on the radio.

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