I also welcome the Bill and commend Deputies Cullinane and Mark Ward and Sinn Féin on bringing it forward. I have to say that it is disappointing that the Government is once again opposing a Bill from the Opposition. This morning, I attended the working group of committee Chairs with the Taoiseach, who spoke very openly about how he is open to taking amendments from the Opposition, listening to different groups and engaging with people in a productive way to have a productive Parliament. I was surprised because it is not my experience. I have been here a year and not a single amendment put forward from the Opposition benches has been accepted by the Minister for Health - not one. Not a single Bill we have put forward has been accepted in a year. At the same time, Ministers and the Taoiseach in particular, especially at Leaders' Questions, come in and say the Opposition has no ideas, solutions or proposals. When serious proposals are put forward, they are just dismissed out of hand and given no serious consideration. It is deeply frustrating. We saw it yesterday when my party put forward a Bill on animal welfare. It was similar with our votes at 16 Bill and our Bill in the Seanad on domestic violence. Time and time again, there is a timed amendment, our legislation is dismissed and we are told we have no ideas. When a very well-constructed and serious Bill like the one put forward by Deputy Cullinane is put forward, again it is opposed. I am only here a year and I find it deeply frustrating. I am sure others who are here longer find it even worse. People outside the Houses, including the citizens watching this debate, do not have trust in our democratic system and process because we have a system that is two-faced in many regards. On the one hand, the Taoiseach says he is very open to accepting amendments, listening to the Opposition and engaging. On the other hand, the Government just dismisses proposals and suggestions out of hand. I ask the Government and the Department of Health, which has not accepted a single amendment to any legislation in a year, to think again about the strategy and approach, to engage meaningfully with the constructive proposals put before them and to stop dismissing things out of hand because it is bad for our democracy, our Republic and our governance and we can do better. I welcome the Bill. The main provisions about putting waiting list targets on a statutory footing, publishing all waiting lists across the health service and making the NTPF more accountable to the Dáil are things all parties here should accept and progress. Sláintecare set out the core wait times of ten weeks for outpatients and 12 weeks for inpatient day cases. These wait times were to be underpinned by legislation and implemented on a phased basis by 2023, but that did not happen. Is the Government now opposed to the idea of legislating for wait times because that is what I heard from the Minister of State's speech? Is he now against that and going against the recommendation from Sláintecare? If so, I would like him to tell us more about that. In February, the Minister published the waiting list action plan for 2025 with the aim that 50% of patients would wait less than the Sláintecare target of ten weeks for their first outpatient appointment and 12 weeks for their day appointment by the end of 2025. In October, which is the last published month, outpatient appointments were 69.4% over the target, while active inpatient and day cases were 62% over the target. Time and again, we are missing those targets and people are waiting far too long to get access to the health services. Supply-side interventions are needed for investment in primary and community care so that our hospitals are not the default but supply-side policies alone will not address the waiting list problems. Sláintecare is clear on the requirement for maximum wait-time guarantees and the need to ensure that people responsible for holding those guarantees are held to account. This is why we need legislation like this. Currently, the NTPF publishes monthly acute hospital waiting lists and some diagnostic waiting lists. However, those for other areas, such as primary care, are not routinely published. Instead, these must be sought via parliamentary questions, as they are not routinely compiled. This makes it very difficult to get a true picture of the total number of people on health and social care waiting lists in the State and, most importantly, to provide a true picture of the wait times across services. Waiting times in primary and community care are the hidden crisis in our health services. In September, figures I compiled showed there are over 300,000 people on some of our primary and community health and social care waiting lists. Over 240 have been waiting for more than three months, while more than 100,000 people have been waiting for over a year. An extraordinary number of people are waiting an extraordinary length of time to get access to health services in this State. Quite shockingly, 42,000 children were found to be waiting for more than a year across eight core primary care services, including occupational therapy, physiotherapy and speech and language therapy. A massive number of children are waiting far too long to get access to these core primary care services. On NTPF accountability, while the NTPF is required to appear before the public accounts committee, as specified under legislation, and potentially other committees, such as the health committee, there is undoubtedly an arm's-length level of accountability, which needs to be rectified. Instead of being a response of last resort, the NTPF has regrettably become an integrated part of the State's healthcare landscape. The health service has become increasingly reliant on the NTPF, which has a €230 million budget this year compared with €55 million in 2018. We have seen this balloon and balloon, with massive expenditure. A HSE examination over a 27-month period revealed the scale of the HSE's dependency on insourcing and outsourcing. A total of €830 million was spent on outsourcing and around €100 million was spent on insourcing. Huge sums of public money are being spent. While greater controls have been put in place until insourcing is phased out in June 2026, little is being done to address the dependency on outsourcing. This is something that needs to be addressed. The reliance comes at a major cost that is not just financial. It is hollowing out public capacity and creating a perverse incentive for staff to move from the public to private sector. It is a vicious cycle. I would like to hear about the Sláintecare commitment around the legislation and what the Government's current position is on that, and what else will be done to reduce waiting lists. Too many people in our State are waiting far too long to get access to core health services they desperately need. People are waiting in pain and anguish. They are getting sicker and, ultimately, dying sooner because they are not getting access to health services. This Government and this State are failing too many people. It needs to change.

Sentiment score: 0.09