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Estimates for Public Services 2016 (Resumed) (Continued)

Thursday, 16 June 2016

Dáil Éireann Debate
Vol. 913 No. 3

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(Speaker Continuing)

[Deputy Jackie Cahill: Information on Jackie Cahill Zoom on Jackie Cahill] The 65 to 74 age group is set to grow by over 33% and the 75 years plus age group is set to grow by an incredible 82%.

We need careful planning to ensure the health service, which has come in for extensive criticism in recent years, does not run into even more trouble in the coming years. Deputy Healy referred specifically to South Tipperary General Hospital, Clonmel. Some things could be done in Tipperary which would not cost a great deal to the HSE budget. Our Lady's County and Surgical Hospital, Cashel, is fully furnished but its doors are closed. It must be re-opened as a set-down facility. The Dean Maxwell facility in Roscrea, a residential home for elderly people, urgently needs investment and more beds are required. Mount Sion in Tipperary must be kept open as a residential home for people with mental illness and the Community Hospital of the Assumption in Thurles also needs more investment and capacity.

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I wish to begin by thanking everyone for their contributions. We have had a constructive debate. There is significant merit in much of what has been said on all sides of the House.

It is fair to say that today is a good day for the Irish health service. Any day when those of us in the Oireachtas decide to spend an additional €500 million on the Irish public health service can only be described as a good day. It is evidence that we are putting the fruits of our functioning economy to work for the public services that our citizens rightly demand.

This Revised Estimate does five things. First, it puts the health service on a stable footing. These are not my words; they are the words of the director general of the HSE. It is now up to him and his managers throughout the service to manage and live within their budgets. That is what they are paid to do and that is the job they must do.

It also does four other things. It allows us to have money for a winter initiative larger than the winter initiative last year. A total of €40 million is included to ensure we can put additional supports into our emergency departments for the winter period, a time when they come under particular pressure. It allows us to restore the mental health budget to €35 million, as outlined by my colleague, the Minister of State, Deputy Helen McEntee. The Minister of State will be getting on with drawing up plans to spend that money. It allows us to increase home help hours and home care packages rather than simply keep the levels we had in 2015. It allows us to have more home care packages and home help hours this year than last year, a welcome development. As outlined by my colleague, the Minister State, Deputy McGrath, it has allowed him to increase the disability budget by €31 million, including €3 million specifically for the important issue of school leavers.

This debate has been constructive in the sense that there has been recognition on all sides from all speakers that we cannot do things the way we used to do them in budgeting for the health service or in debating the health service. We need to try to find consensus, where possible, on the general direction of travel for the Irish public health service. That is why I have undertaken to co-operate and work with the establishment of the special committee to develop a single vision for our health service for the next decade. I am a supporter of the committee. Ministers of Health come and go. It is not fair that every time a new Minister arrives the health service gets tinkered with but there is no continuity in direction. I do not underestimate the challenge being put up to this committee, but I am certainly looking forward to working with Members in this regard. Reference was made to a short timeframe of six months and I agree, although that was the timeframe put forward in the motion. It is now a matter for that committee to do its work and see how it gets on in that timeframe.

Today, we published the national health care quality report. I wish to make a point for our front-line staff. There are major challenges in our health service. We have discussed the challenges and problems as we always discuss problems - that is our job. I urge our front-line staff to read the report. It is available on my Department's website. It shows the progress we have made. When I say "we" I am not referring to the Government, but "we" as in the Irish public health service. It will show the progress through successive Governments and improvements in outcomes in our health service. It is important that front-line people working in our health service today have that acknowledged by Members and by the media as well. Good things are happening in the health service every day.

There are still significant challenges, some of which have been referenced today. I take the point Deputy Kelleher makes about people talking about primary care since the time Dr. Rory O'Hanlon was Minister for Health in the 1980s. He is right. We must show significant progress. I agree that we cannot simply measure progress in terms of the number of primary care centres built. We must consider what happens in primary care centres and how many services and facilities can be provided in the community which, previously, had to be provided in acute hospitals. I have strong views about this. A crucial element of this is the new general practitioner contract. We have not had a new GP contract in 44 years. The patient values the relationship with the GP and the State must value that relationship as well. We will get the negotiation for a new GP contract under way. We also need to look at the provision of diagnostic equipment in the community. The programme for Government refers to incentivising health care professionals who purchase and place diagnostic equipment in the community in order that patients can get a scan or X-ray in primary care centres or GP centres rather than having to go to the emergency department.

I am keen to debunk some myths. I am all in favour of constructive politics, but I get frustrated when people try to say that I represent something that I absolutely do not represent. Deputy Louise O'Reilly is very constructive and I enjoy my engagements with her, but she referred to a charter of privatisation. That is nonsense. She referred to cuts to the overall health budget. There are none. We are giving an extra €500 million today. She referred to this representing bad news. If we are going to have an honest debate, then let us have an honest debate. This Government and I are committed to the development of the Irish public health service and to a singular vision for the development of that public health service in which access to services is based on need and not ability to pay. That is what I want to work towards with this Oireachtas. This Oireachtas is diverse but we need not necessarily be divided on all these issues.

We have significant challenges but I believe that putting the additional funding into our health service today - provided the Oireachtas chooses to pass this Estimate - will enable the HSE to get on with the job of providing the services that people need and will enable us to make the necessary service improvements.

Debate adjourned.


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