Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I am allowed to comment politically in the House as I wish.

I am grateful for the opportunity to speak on the Bill. I very much appreciate Deputy Harty's intention in bringing it forward. I fully accept his bona fides and I share his ambition, as do all Members, to bring about universal healthcare through Sláintecare. I wish to make clear to the Deputy and the House that I have an open mind regarding the embedding of economic and social rights in the Constitution. Any comments I make in my contribution, even those critical of the wording of the Bill, are intended to be constructive and advance this debate because through the Bill, Deputy Harty is challenging us to consider whether we should ask the people of Ireland to insert these rights, whatever the wording may be, in Bunreacht na hÉireann. We need to carry out a significant body of work to arrive at the answer to that question. I am willing to engage constructively and keep an open mind on the matter.

New politics and the make-up of this Dáil is often criticised in the media and political discourse. One of the big successes of new politics and the minority Government has been that all sides of the House worked together on the Sláintecare report. Deputy Harty was a member of the committee and played an invaluable role on it. We now have a joint unified vision of the type of health service we wish to create. That vision is not mine or Deputy Harty's but, rather, is owned by us all. There has never previously been universal agreement in the Oireachtas on the direction in which we should travel. There will be more talk about universal health insurance or the model changing if the Minister changes. Rather, we share one vision.

I very much respect the motivation behind the Bill but I am advised that it requires serious consideration. That is no fault of the Deputy. The Bill was published last week and happens to have moved to Second Stage this week. In light of the significant impacts it could have on the State if ample time is not given to genuinely reflect on its provision, I have tabled a reasoned amendment which I discussed with the Deputy. It seeks to postpone the Bill for six months, during which time the Sláintecare implementation office of my Department which is considering the issues of eligibility and entitlement will consider the Bill in the context of its work. Consideration would also be given to the proposals of the Convention on the Constitution on this issue. Several NGOs, including Amnesty International, have put forward suggested wording. We would use the six months to consider all the issues and report back to the Joint Committee on Health, which is chaired by Deputy Harty. That would keep the issue alive and give a timeline to carry out what is a very significant amount of work. I hope the amendment will be accepted in that vein. No Deputy wishes to insert wording into our Constitution which could have unintended consequences. That is not the purpose of the Bill.

The Oireachtas Committee on the Future of Healthcare heard from diverse stakeholders and received many submissions before formulating its final recommendations. We now have its ten-year reform plan with unprecedented cross-party consensus and support for delivering a universal health service in Ireland. We should not forget that Sláintecare, to which we have committed, is a programme for reforming our health and social care services. Eligibility and entitlement, which are to the core of the Bill, formed a key part of the discussions and final recommendations. Although the Sláintecare report called for universal entitlement to a broad package of health and social care services, the committee recommended that this be achieved through primary legislation and acknowledged the need for phased implementation, with entitlement and waiting times being phased in over a period of five years. This approach recognises the need to build capacity in tandem with rolling out entitlement. Although there is wide-ranging agreement that Ireland should move in the direction of a universal single-tier health service - God knows it is overdue - it is acknowledged that this goal presents several challenges and a significant amount of work. We need to give careful consideration to how we bring that about.

I am glad to highlight some of the work under way to achieve the Slåintecare vision of a universal single-tier health and social care service where access is based on need, and not ability to pay. I hope the reforming agenda on which we are embarking is evidenced by our implementation plan, the new programme office, the reforms we have agreed with GPs and the publication of the de Buitléir report which outlines that we wish to pay our consultants more and we wish for them to undertake public practice rather than private practice in public hospitals. I genuinely hope we are embarking on that agenda together and that it will continue through the lifetime of this Dáil and into the next.

In theory, a constitutional right to health sounds positive and I have no doubt it is intended as such. However, the scope and limitations of the right to health which the Bill sets out to guarantee have not been explicitly determined. I make these comments constructively and wish to put forward a few counterpoints. There is a lack of clarity on what an individual's right to health and healthy conditions would look like in practice. Although Deputy Harty has carried out a significant amount of research on developments in other jurisdictions, it is not as simple as transposing them into an Irish context.

I welcome and share the Deputy's overarching view of health under a banner of "health protection", which is intelligent wording. This would account for wider socio-economic factors and the importance of health promotion. We frequently talk about illness and its management, when the protection of someone is at the core of the right we want for all our citizens. However, we have a body of work to do for us to form a more coherent understanding of what a constitutional right to health protection would guarantee. In the absence of that, we could create problems down the road.

The Bill seeks to put only the right to health into the Constitution. Therefore, we would be making a conscious decision to elevate the right to health above other important social needs. When the Constitutional Convention and a number of NGOs looked at this, they took the view that we should insert a number of socio-economic rights into the Constitution-----

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