Sinn Féin’s David Cullinane TD: ‘A prescription for change’ in healthcare
January 2025 was another record-breaking month in healthcare, but in the wrong ways, writes Sinn Féin’s spokesperson on health, David Cullinane TD, outlining his party’s alternative vision.
In January 2025, the Irish Nurses and Midwives Organisation recorded nearly 14,000 people inappropriately admitted to hospital on trolleys and chairs – the most ever recorded in a single month. In early 2006, then-health minister, Mary Harney declared a national emergency when there were less than half as many patients recorded on trolleys.
The HSE has since confirmed to me that January 2025 was also a record-breaking month for hospital cancellations – where a capacity problem with a hospital, not a clinical problem with the patient, leads to a cancelled appointment – with 5,000 more cancellations in January this year than in January 2024. There were 20,000 more appointments cancelled in 2024 than in 2023.
This is all part of a broader trend, and sadly it is unsurprising to those of us who watch healthcare closely. That is why, when I was appointed Sinn Féin’s spokesperson on health in 2020, I set out to develop and publish the most comprehensive healthcare plan ever produced by a political party to demonstrate that the problems are not intractable, can be solved, and will be solved if there is political will.
My starting point is that each of us deserves a fit-for-purpose health and care system that supports us through life, illness, where a person has a disability, and as we age, regardless of income, wealth, or background.
Our plan, A Prescription for Change (2024), sets out in detail how we would deal with the big challenges in healthcare: tackle overcrowding, reduce waiting lists and wait times, improve patient safety, and deliver free-at-the-point-of-use healthcare. This plan is available in web format and for download at health.sinnfein.ie.
Sinn Féin would work across the 32 counties to develop a first-class, single tier, all-Ireland public health system that learns from the best and worst in both jurisdictions and across Europe. We would recognise physical and mental health as a human right. To deliver safe staffing levels we would boost training numbers, give trainees a proper bursary, give graduates a job guarantee, and work to attract our healthcare workers to relocate back home. Solving the housing crisis is a key part of improving the health workforce, and Sinn Féin has outlined comprehensive and radical plans to do this in Eoin Ó Broin’s A Home of Your Own (2024).
A Sinn Féin Taoiseach would appoint a ‘Minister for Health and Social Care’ to be the driver of the reforms set out in our manifesto. We would establish cabinet committees on health and on workforce planning, which would include a major focus on the health sector. The underpinning principle of reform should be that people can access the right care, in the right place, at the right time, and at the most appropriate, cost-effective level, with a strong emphasis on prevention and public health. We would ensure rights-based access to care for disabled people, and inclusive mainstream services.
A Sinn Féin Government would set a zero-tolerance approach to hospital trolleys and overcrowding as a target for all hospitals. To achieve this, we would deliver 5,000 hospital beds by 2031, including replacements for 1,000 unsafe beds. We would also invest in diagnostic capacity, theatre space, and aligned discharge capacity in the community, and accelerate the delivery of public only elective hospitals. This would be underpinned with community care reform, including 2,000 community step-down, nursing care, and social inclusion beds, and legislation for safe staffing levels.
Sinn Féin would take big bold steps to deliver universal healthcare by providing free prescription medicines for all households, upgrading every GP visit card to a full medical card, providing full medical card cover to all workers up to the median income, and abolishing prescription and car parking charges.
In the first 100 days of a Sinn Féin government, we would legislate for free prescription medicines and for medical card entitlements for all up to the median income, to be rolled out over 5 years. We would deliver a ‘Healthcare for All Act’ to commit the State to full public health cover by 2035.
“I set out to develop and publish the most comprehensive healthcare plan ever produced by a political party to demonstrate that the problems are not intractable.”
David Cullinane TD, spokesperson on health, Sinn Féin
A Sinn Féin government would deliver on the commitment of Sláintecare to deliver the right care in the right place at the right time. This would be achieved by upgrading and expanding local health services with a landmark new public GP contract, hiring public dentists, delivering a ‘pharmacy first’ model for minor ailments, and ramping up home- and community-based care. Our comprehensive plan covers essential measures to reform home care, expand GP and primary care, deliver community neuro-rehabilitation teams, and reduce pressure on hospitals.
A Sinn Féin government would not tolerate an understaffed and under-resourced mental health service. At the heart of Sinn Féin’s plan is a new ‘Child and Youth Mental Health Service’ to replace Child and Adolescent Mental Health Services (CAMHS) which would provide integrated early intervention services for children and young people to the age of 25, expand access to Jigsaw and primary care mental health services, deliver universal counselling, fund the full complement of inpatient and intellectual disability CAMHS teams, and deliver 20 more early intervention in psychosis teams.
A Sinn Féin government would implement an unprecedented 10-year investment programme to deliver a rights-based approach to disability services. This would provide for unmet and future need, and fund accessible therapies, respite services, residential care and de-congregation, personal assistance services, home support hours, day services, and access to specialist and mainstream community services.
Sinn Féin would deliver a €15 billion health capital investment programme over a term of government. We would immediately provide funding certainty for 5,000 acute hospital beds. This ambitious and future-focussed capital programme includes estimates for four new elective hospitals, the new maternity hospital, surgical and diagnostic hubs, new primary care centres and community facilities, 5,000 hospital beds, theatre capacity, nursing homes, equipment, machinery, ambulance fleet, and other significant and minor infrastructure works. It also includes estimates to maintain existing stock, advance climate action, and meet regulatory standards. We would specifically ringfence €2 billion for a Digital Transformation Fund.
Our ambitious plan for health and social care includes, but is not limited to women’s health, children’s services, national strategies, all-island planning, public health, social care, disabilities, older people, chronic disease management, gender and sexual health, prevention and health promotion, and climate action in health.
The health service needs investment, but it also needs very serious reform. Investment and reform must be aligned to ensure that the taxpayer is getting value-for-money, and that the health service is modernised and equipped to operate in the 21st century. That will take big upfront investments in new digital systems and equipment, but if managed properly this investment would pay itself back by cutting down waste, inefficiency, and enabling healthcare workers to focus on delivering care instead of chasing paperwork. To make sure that the health service is being held to account for spending of public money, we would set a €1 billion target in savings and efficiencies by 2030 to pay for these investments from within the existing budget.
While this plan was developed for the November 2024 general election, its comprehensive nature means it will continue to be relevant for years to come. In the Dáil term ahead I will continue to put forward comprehensive solutions to deliver the best health service that Ireland can offer and which our people deserve.
