'We need to put more pressure on Europe to give us a fairer deal'

During Week 27 I had an opportunity to speak on different issues relating to Health Services delivery in Wexford and their impact on the community. Here is an extract from my address to the Minister for Health James Reilly, “I will start on a positive note by commending the Government on going ahead with funding for accident and emergency and maternity units in Wexford, which were much needed. For some strange reason, Wexford has been poorly treated for a long time. It has one of the highest literacy rates in the country yet it is one of the few counties without a third level education institution. At present, Wexford has one of the highest rates of unemployment, with more than 20,000 people unemployed. Even in the good days in 2007, there were 50% more Wexford people working outside the county than in it. It is welcome that Wexford is getting the much-needed hospital unit.

What is less positive is that in Wexford yesterday, 24 beds were closed and 15 patients were on trolleys due to the manager having the sole job of meeting a certain budget. It is hard to blame her because her job seems to be to cut patient care in order to meet the budget…Given the amazing statistic that the population of Wexford increased by 10% in the past five years, going from 131,000 to 145,000, one can imagine the extra pressure on the hospital. This is most noticeable in the maternity unit. At present, there are 40 whole-time midwives working 37.5 hours per week. The moratorium on recruitment and the fact that the maternity unit is part of the general hospital means the hospital cannot hire midwives, irrespective of demand. This year, the hospital has seven fewer midwives because of the moratorium and it is about to lose another three before Christmas. One wonders how they make this work and, from what I understand, it happens because of the goodwill of the midwives, which involves working through lunchtime, working late hours and receiving no overtime rate for this work. I am not sure how long this will last and, given that the situation will become worse if the moratorium is left in place, I fear for what will happen.

It is accepted that there is a direct correlation between financial problems and mental health. The Minister of State, Deputy Lynch, was present at the launch of a recent report by the Mental Health Commission entitled The Human Cost. This provides an overview of the evidence on economic adversity and mental health, as well as recommendations for action. Speaking at the launch of the report, the Chairman of the Mental Health Commission, Dr. Edmond O’Dea, said that the recession affects everyone, that for those with pre-existing mental health problems, issues such as debt and unemployment are likely to make things worse and that “in addition to the effect on people with pre-existing mental health problems, people with no previous history of mental health difficulties can be affected.” Some of these individuals may have little previous experience of coping with hardship or financial insecurity.

From 2008 to 2009, there was a 24% increase in suicide. Suicide is a major problem in Wexford and just today in my village, a man a few years younger than me took his own life. The Minister of State is aware that the mental health institution in Wexford, St. Senan’s, was closed earlier in the year. Some 75% of the patients go to Waterford and 25% go to Newcastle, County Wicklow. The facility in Newcastle, used by those in the north of County Wexford, is an excellent, state-of-the-art facility. However, the facility at Waterford is not fit for purpose, as conceded by the Minister when he was in opposition…The Minister informed me in this House in May that a new crisis house would be opened in Wexford to replace St. Senan’s Hospital which would ensure we would not be too dependent on services in Waterford. The new unit which is about to open at St. John’s Hospital in Enniscorthy is being sold as an acute admissions service, but it is essentially a rehabilitation facility for patients coming from Waterford and Newcastle. That is not good enough.

Last week there were reports that mental health services in Wexford were likely to face further cuts in the near future. Following the closure of St. Senan’s Hospital, community services in Gorey, Wexford and Enniscorthy were upgraded to be available seven days a week to cope with demand. However, we are now told there is a possibility this service will be reduced to five days owing to cutbacks. The Mental Health Commission has highlighted the connection between primary care services and mental health services and that the majority of common mental health problems are treated at primary care level. Further reductions in primary care provision will make the job of front-line workers extremely difficult.

A 2011 report by the World Health Organization on the impact of economic crises on mental health observed: “It is well known that mental health problems are related to deprivation, poverty, inequality and other social and economic determinants of health. Economic crises are therefore times of high risk to the mental well-being of the population and of the people affected and their families.” The economic crisis that began in 2007 has led to significant declines in economic activity, a rise in unemployment, a depressed housing market and an increasing number living in poverty. It continues to pose major challenges in health service delivery in the south-east region.”

I began Week 29 with a challenge to the Minister for Finance Michael Noonan on the madness of this State continuing to pay the unsecured bondholders of Anglo Irish Bank – we were just about to part with €715 million while inflicting unreasonable austerity on the most underprivileged in our society. Our government must show more courage and leadership in dealing with the EU and the ECB. It beggars belief that financial investors and institutions who gambled poorly on Anglo Irish Bank should still receive full payment at the Irish taxpayer’s expense – you couldn’t make it up. Here is an extract from my speech, “I accept that the Minister for Finance has been dealt a terrible hand, but I think the goalposts have moved in Europe. I do not think we should continue to give a certain impression to the Europeans about things. We are eager to be positive and there is nothing wrong with that. However, we are not calling our position as stark as it might be. I wonder if Chancellor Merkel is quite aware of just how difficult things are for many Irish people. It is all very well for her to stand up in the Bundestag and say nice things about us and how well we are doing. I would like her to come over here and have a look at some of the things that are going on here at the moment owing to the austerity measures we have been obliged to introduce.

Our domestic economy is in a poor place. Life is so difficult for 450,000 people who are unemployed. We are cutting learning support, SNAs, and language support to the marginalised in our society. We are closing hospital beds to balance budgets. If Chancellor Merkel came over here, perhaps she would be a little bit more sympathetic…The Minister is saying that if we were to refuse to pay the unsecured bondholders on this occasion, it would likely result in Armageddon and it would be a bit of a disaster. The rules are changing. Things are not as they were in Europe even last month, and they will change more. Bondholders will take it on the chin a lot more, and not just what they took in Greece last week. They will be taking more haircuts in the next two years. I am not saying we will fall out with the Europeans, but we need to put more pressure on Europe to give us a fairer deal. Everybody realises at this stage that bondholders will not continue to get all their money in the next two years. It is time the ECB got real and took that on board in dealing with our problems.”