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Dáil Diary no 10- 5 Feb 2015

4 Years of Promises, And still no Dialysis Services for Wexford...

One of the most pressing problems in Ireland is that our Health Service leaves too much to be desired. This is as true for Wexford as any country, where there is a range of challenging health issues which need to be addressed. One of them is that despite promises to the contrary, there is still no operational satellite Dialysis unit in the country. There are at least 39 elderly patients who are being put through the ringer, having to be taxied in a mini- bus to Waterford, three days a week – being picked up at 7:30 in the morning and not back till 7 in the evening. A legal battle between two big companies is blamed for much of the delay, as the Government fails to find the necessary funding in their own budget to invest in the project – but were able to pay the bondholders of failed, useless Banks. Here’s my Leader’s Questions today with Tánaiste Joan Burton -

We have been told that Wexford will have an operational satellite dialysis unit in July 2016. Four years of delays in implementing this have led to significant disappointment in Wexford. As the Tánaiste may know, the Health Service Executive, HSE, intended to have such a service operational in Wexford by 2012. However, we were told this was not achievable due to a legal challenge by private dialysis providers to the tender award for the contracted satellite services in Dublin. A company called Fresenius Medical Care (Ireland) Limited, part of a €20 billion corporation, secured an injunction restraining the HSE from awarding the contract to another company, Beacon Medical Group. The dispute concerned the contract in Dublin but has impacted strongly on Wexford with a two and a half year legal battle and a four-year delay.

Meanwhile, 39 Wexford dialysis patients have to be taxied from Wexford to Waterford three times a week. When I queried the costs of this with the HSE, it informed me it costs €38,330 a month to taxi the 39 patients back and forth, €460,000 a year. Worse still is the incalculable cost to the well-being of the dialysis patients affected. The majority of these patients are in their 60s. I spoke to one of them recently, a man who is almost 80. He spends 400 hours a year, that is 50 eight-hour days, just travelling in a minibus from his home in Wexford to Waterford Regional Hospital for dialysis. His daughter Bernie said to me- “Dad is collected at 10.30 in the morning, home usually at 7 p.m. with a five-hour dialysis session in between, Monday, Wednesday and Friday. This journey in a minibus in the cold and wet is tough for any individual. For many of Wexford's elderly, it amounts to abuse.”

As the promised Wexford service was private rather than public, it has been held up by this injunction. There is something seriously wrong with the idea that a private company's action in court can have such an impact on the provision of a vital health service in Wexford. Does the Tánaiste believe this is good enough?

The Tánaiste: The generally accepted best medical standard for dialysis treatment is to have it as close to the patient as possible either through their local hospital or other local health services. In some cases, it is now possible to do this at home or in a local community-based facility. My understanding from what the Deputy said is that due to a legal challenge arising from a dispute between private operators, the operation of such a service in Wexford appears to have been delayed.

As it is subject to a legal challenge, and I do not have the background details of the dispute, I am not able to comment on it. The general principle is to develop the network of dialysis facilities around the country so as to be as close to the patient as possible. I agree with Deputy Wallace about the letter he received from the patient's daughter. For somebody requiring dialysis, it is very difficult to end up travelling a long distance over a long day to get essential treatment…

Mick Wallace: The core of the problem is that we have a situation where a service to the public is delayed for four years because of a battle between private companies. The Tánaiste might clarify this for me as I do not know for certain, but it sounds to me like a version of a public private partnership, PPP. Sadly, we do too many things now through PPPs. When vital public health services are delayed for four years because we have chosen to go down the private route rather than the public, this is at the source of the problem. We should not be allowing these multi-million euro corporations delay much-needed services to public patients. It is ridiculous.

Regularly, the Government boasts that we can borrow money at 1.7%. Why have we not challenged EU rules so that we can borrow money at 1.7% and use it for infrastructure development, investment in health and other areas rather than being driven into the hands of the private sector in the form of PPPs?

The money ends up costing somewhere in the region of 15%, not 1.7%. The EU rules are forcing states to make private investors fat. That is what is happening, and we are not challenging those rules.

Surely the Tánaiste must agree that it is a crazy situation. We cannot have a situation like that in Wexford, where people are being driven to hardship while the State is not dealing directly with the challenges that are offered because of EU rules. Can the Tánaiste please find out if this is a PPP arrangement or a version of one? I do not expect her to have that answer now. Can she tell me whether she agrees that we should be challenging the EU rule that stops us from borrowing money at less than 2% to invest in public services and infrastructure and that instead drives us into the hands of the private sector in the form of PPPs?

The Tánaiste:  As regards Ireland borrowing, the Deputy probably knows that this week, Ireland was in a position to borrow €4 billion on a 30-year basis, a very long-term basis for raising debt, at just around 2%. That is what makes us so different from other countries that are still experiencing enormous difficulties…

I am not familiar with the details of this legal dispute, so I do not want to comment on it. Nor do I know whether or not it is a PPP - it may well be. I broadly agree with what Deputy Wallace is saying. If it is possible to borrow much more efficiently and cheaply on the international markets - as we have done this week - and also to roll over a €9 billion portion of our previous IMF debt and re-borrow it at a much cheaper price - as we did before Christmas - that is certainly the way to grow national capacity in order to have the money for all the capital investments we require…

I agree with Deputy Wallace that it depends on the terms, rates and conditions, but I do not want to comment on the specific case. I will ask the Minister for Health to give me some information about the cases the Deputy has raised. I fully accept his proposition that it would be so much better for this man - I understand it is a man in this case - to be able to get the dialysis services he needs as close as possible to where he is living. As Wexford Hospital is a very fine hospital, I hope that in due course it will be available there for him.

 

Mick Wallace.

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