Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I am almost afraid to endeavour to answer the questions considering that the Deputy answered some of them more ably than I could. I reassure him that it remains my position to advance the restructuring of the health service in line with the Sláintecare report. Regional integrated care organisations - we will not call them RICOs because that relates to racketeering in South America - will achieve the aim of having integrated structures that deal with acute hospital care and primary and social care. There will be one structure in each region rather than multiple structures. It is my intention to go to Cabinet before the summer recess to seek approval for those structures in line with the Sláintecare report. That will be a very important moment for the health service because one does not change structures for the sake of it; one changes them if they will be enablers for change and reform. There is no doubt in my mind that one cannot reform the health service while continuing with two separate structures in the hospital groups and the community health organisations. We must have one structure that provides an opportunity, as alluded to by the Deputy, for greater devolution to the regions, a smaller national centre and HSE, more devolved responsibility to the regions and more accountability and oversight at regional level. I do not mean this as a criticism, but it is often a source of great frustration to Deputies that they must ask questions on certain issues on the floor of the national Parliament. They would prefer to get more efficient and localised answers from a regional structure. The bringing forward of those proposals before the summer recess will be a very important moment in terms of advancing Sláintecare and ensuring there is no going back, that the Sláintecare train has left the station and everybody needs to get on board.

The Deputy referenced chains of command, governance and so on. I reassure him that it is still my intention that the new HSE board will take office in June, which is very important. At this and other committees, Mr. Reid's predecessors and other HSE representatives have alluded to the somewhat bizarre governance structure which is in place and which needs to be reformed. The new board will take office in June, subject to the Oireachtas doing its business. I hope to have the co-operation of the Dáil and Seanad in that regard.

On the issue of waiting lists, as we all know, there will always be a list because as soon as one person is treated, another will need treatment. The issue is how long people wait for treatment. We are making good progress. I accept that we have a significant amount to do in the area of outpatients - there were some good exchanges earlier in that regard. It is important to note that there are 9,119 fewer of our citizens awaiting a hospital operation or other procedure at the end of April this year than at the end of April last year. That is a direct result of some of the investment decisions we made in recent times.

I will revert to the Deputy in writing with the exact breakdown on the NTPF. Almost all NTPF expenditure is within the jurisdiction. A very small number of procedures for scoliosis and so on were carried out elsewhere, but almost all procedures occur within the jurisdiction. Importantly, a higher percentage of the NTPF budget is now being spent within the public health service. I always remind my HSE colleagues that the NTPF should not be seen as just a fund for private hospitals. That may have been the case in the old days. There is every opportunity for public hospitals which have capacity. We have capacity to do more, particularly sometimes in our smaller hospitals, and we have seen some exciting proposals in that regard.

I refer to the €1 million we gave to the NTPF to open a new cataract theatre in Nenagh hospital last year. In that instance, we used a public hospital and NTPF money to sort out cataract waiting lists in the mid west. Perhaps Mr. Reid might like to add something.