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Confidence in the Minister for Health: Motion [Private Members] (Continued)

Tuesday, 18 September 2012

Dáil Éireann Debate
Vol. 774 No. 1

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(Speaker Continuing)

[Deputy Charlie McConalogue: Information on Charlie McConalogue Zoom on Charlie McConalogue] It is time the Minister reconsidered his position and that the Government reconsidered what type of leadership is needed to deliver the type of health service required by the people.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt The next speaker is the Minister for Health, Deputy Reilly, whom I understand is sharing time with Deputies Buttimer, Rabbitte, White, Corcoran-Kennedy and Walsh. The Minister has 20 minutes and each of the other Deputies has two minutes.

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I move amendment No. 2:

To delete all words after “Dáil Éireann” and substitute the following:

"commends the Minister for Health, James Reilly T.D., for the progress to date on the reform of our health services and for the effective manner in which he is managing resources in a difficult budgetary and economic environment, placing the concerns of patients at the centre of the healthcare system;

endorses the specific measures that the Minister has taken to improve the performance of the service delivery system and to strengthen the overall governance and accountability of the system; and

supports the Minister in his determination to move towards a health system that provides access based on need rather than income, underpinned by a strengthened primary care sector, a restructured hospital sector and a more transparent ‘money follows the patient’ system of funding that will be supported ultimately by Universal Health Insurance."

This motion could be described as political opportunism because that is exactly what it is.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister knows all about that.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary He wrote the book.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly It is the empty noise of a party that ran out of ideas and idealism a long time ago, a party that has damaged each and every family in this country because of the economic collapse over which it presided, a party that sold our nation down the river.

It is a bit ironic to be charged with poor governance by a party that left this Government with the biggest budget deficit in our history; that, through collective incompetency, lost Ireland its economic sovereignty and damaged our credibility and international reputation; that gave new meaning to the brown envelope; and seriously discredited our system of government.

Deputies Kelleher and McConalogue have bizarrely promoted the idea that I went into hiding when the cuts were announced. I was on television the very next day-----

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley Sitting on it, I would say.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly -----reassuring people that they were not going to lose service but that reassurance was lost in all the noise from the Opposition-----

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary From the Labour Party. Deputy Keaveney is not a member of Fianna Fáil.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly -----who went on to cause so much worry that people felt it necessary to sit outside Dáil Éireann overnight. I am truly sorry that I was not able to communicate clearly to them the fact that they would not lose their service.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Why did the Minister not go out to them?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly A number of people have said that I abolished the HSE board and the HSE. First, the board is to be abolished but is not yet abolished and, second, the HSE has not been abolished.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley The Minister is looking for a fall-guy.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly Deputy Dooley has contended that 33 people have died because reconfiguration did not take place. I would be happy if he could provide me with the details of what happened.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher The Minister said they would die.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley On a point of clarification-----

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt No.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley The Minister has misrepresented what I said.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am going to leave that now.

(Interruptions).

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly A Leas-Cheann Comhairle-----

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath I was told to sit down earlier.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath Where is Deputy Tom Hayes now.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputies, please. This is a very limited debate.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am not going to spend the evening-----

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley The Minister has asked for clarification.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt The Deputy can send it on to him. He may not do so now.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Leas-Cheann Comhairle is not being equal.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputy Dooley can clarify the matter in his own time.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath No.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley The Minister has asked for clarification.

Deputy Mary Mitchell O'Connor: Information on Mary Mitchell O'Connor Zoom on Mary Mitchell O'Connor Sit down.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath How come I was stopped and told to sit down?

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputy Dooley is sitting down.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Why was I told to sit down? We should have equal play here.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt That is enough.

Deputy Mary Mitchell O'Connor: Information on Mary Mitchell O'Connor Zoom on Mary Mitchell O'Connor Could we hear the Minister?

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley On a point of order-----

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt I will allow a point of order but not a speech.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley On a point of order, am I correct in saying that if the Minister in the course of his contribution requests a speaker to provide information and gives way that person can provide the information? Is that not within the rules of the House?

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt That is not a point of order. If the Minister wants clarification I presume the Deputy can provide it later but not now.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley I am ready to do so now.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt No. The Deputy has already spoken.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly A Leas-Cheann Comhairle, I presume I will be allowed the extra minute speaking time which the Opposition has taken up.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt I call the Minister.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath This is totally unfair.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am not going to continue to engage here tonight in the normal political rhetoric that is the style across the way.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister set it up.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly Rather I am going to deal in facts and measurable outcomes.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary That is a change.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I would like to say at this stage - to paraphrase Bill Clinton - what Fianna Fáil is giving out about is the speed with which this Government is clearing up the mess it made.

Deputies: Hear, hear.

(Interruptions).

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly Deputy Martin, who is not here tonight, is the prime designer in chief of this mess. Let us look at what happened. The health budget grew in the 14 years of Fianna Fáil coalition Governments by more than 320%, from €3.6 billion to €15 billion. During his time as Minister for Health, Deputy Martin spent €13.8 million on management consultancy.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Who negotiated for the GPs?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly With all that advice and increased funding one could have expected balanced budgets. Instead, what we find is that during his tenure as Minister for Health, Deputy Martin still managed to over-shoot his departmental budget and had to be bailed out with supplementary budgets amounting to €664 million. Between 1997 and 2010, Fianna Fáil's period in office, €2.2 billion was spent on supplementary estimates. Deputy Martin as health Minister during the best economic times could not control the health spend yet he has the nerve to criticise those who have controlled it in the worst of economic times.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary How does the Minister define "control?"

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly The challenges besetting our health system are a direct result of Deputy Martin's fatally flawed budgetary and service planning processes.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary That is what Deputy Shortall said about the Minister.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly A recent external independent review highlighted that the governance and control framework in the HSE lacks clarity, is not properly embedded and does not enable effective control to be exercised over voluntary providers. The financing and operating models are tied to antiquated health board structures and there are significant inconsistencies in approaches to analyses and financial performance management and data collection.

Let us not forget that Deputy Martin was the designer in chief of a new health service where he created unaffordable, unsustainable and grossly inefficient bureaucracy. Instead of getting the normal efficiencies that one gets from merging 11 different companies and reducing overheads, we got all the idiosyncratic inefficiencies of 11 different health boards. That still haunts us to this day-----

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley This Government is well haunted at this stage.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly -----in terms of financial reporting mechanisms, different ways of counting things, different ways of coding things, information that is nigh on impossible to analyse.

  All the focus was on inputs instead of looking for outputs and examining outcomes for patients and applying best practise. I have put in place a financial improvement programme and new performance management arrangements are in train. The new finance improvement programme will transform the way financial management is handled across the health system working in partnership with all in the sector, supporting capability and capacity building.

  Patients, not inputs or money, are the priority.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary Hear, hear.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly Patients and what happens to them is what really matters.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath What about the carers?

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I have often said that no matter how elegant the design or how eloquently it is delivered, if it does not improve patient outcomes it is for nought.

  When I became Minister for Health I found systems that do not communicate with each other; no analysis of problems - merely descriptions of them---

(Interruptions).

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly -----and a history whereby my predecessors where informed of budget overruns. It was all about lamh amach agus airgead isteach---

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister knows all about that.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly -----not why have we an overrun and what are we going to do about it. Deputy McGrath was offered an opportunity by the Chief Whip to name the people he says do not support us.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt No, Minister please.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly The Deputy used the opportunity and privilege of the House to make allegations against me.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister should look behind him.

(Interruptions).

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly The Deputy does not have the courage of his convictions.

(Interruptions).

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

Deputy Peter Mathews: Information on Peter Mathews Zoom on Peter Mathews Excuse me, I would like to hear the Minister.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt The Minister has the floor.

(Interruptions).

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am primarily a doctor, a late-comer to politics but I do know one thing.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath I have always said that.

Deputy Patrick O'Donovan: Information on Patrick O'Donovan Zoom on Patrick O'Donovan Give it a rest.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly Can Deputies stop interrupting?

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputies please, there is no need for this. Deputies are completely out of order.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly There is an old maxim which Deputy Mattie McGrath should remember: "Empty vessels make the most noise."

Deputies: Hear, hear.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister is making a lot of noise.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly As a doctor, one does not only look at the signs and symptoms, one must treat the cause of the problem. One has to analyse the cause and must have one's diagnosis before one starts treatment. That is what we have done. The special delivery unit headed up by Dr. Martin Connor analysed why we have overcrowding in our emergency departments, in particular every January. Every hospital is different. We are successfully tackling the causes of overcrowding on a site-by-site basis.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Minister promised there would be no more waiting on trolleys.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly We did not allow that to happen this year. We did not have 569 patients on trolleys in January 2011, which is a little more than 18 months ago.


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