Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the committee for the invitation to attend and I look forward to robust quarterly meetings with the committee.

I am also joined by Minister of State, Deputy Kathleen Lynch, and officials from my Department, including Mr. Jim Breslin, the Secretary General, and Mr. Fergal Goodman, the newly appointed assistant secretary with responsibility for primary care. Mr. Tony O’Brien, the director general of the HSE is also present along with his colleagues from the executive.

I updated the committee last week on how we were dealing with the threat of Ebola. The risk to Ireland is considered very low but we are maintaining high levels of preparedness. We continue to plan and prepare at a national level while engaging at an EU and international level to contribute to and participate in the planning and preparedness process.

Before I continue with my prepared script, I will share one reflection. As someone who has been in the job for about three months, what has been very interesting to me is to compare the health service in which I used to work seven or eight years ago with the one of which I am, at least nominally, now in charge. The focus in health tends always to be on the things that are going wrong, whether it is the number of people on trolleys or waiting lists, gaps in services or difficulties with eligibility. I expect, for obvious reasons, that this committee meeting today will focus on those things that are going wrong. That is fair enough. I point out, however, a few things that are going right and things that have really improved in the health service since I wore a white coat and stethoscope.

To mention a few of them, there are the national clinical programmes led by Dr. Áine Carroll, who is present , and the improvements are phenomenal in areas such as stroke and acute coronary syndrome. People get treatment for their heart attacks or strokes very quickly. There is also the stroke programme. A person's life is saved every day who would have died when I was a doctor, not because I was a doctor but because health care was different in those days. In addition, every day a person who would have become disabled does not become disabled because of our stroke programme. That is just one example of such programmes.

We have HIQA inspections. While they can be very annoying for staff who can find them unfair, I have no doubt that standards have been raised because we inspect and investigate things now that would not have been investigated in the past. We need to realise, when we hear about HIQA inspections in the news and when HIQA highlights bad things, that is in some ways a reflection on an improving health service. Such issues would have gone uninspected and unreported ten or fifteen years ago and would not have been acted upon.

We have greater access to health care free at the point of use than ever before. Two million people have medical cards or a doctor visit card. That is more than was ever the case.

In respect of hospital acquired infections, MRSA rates are falling and have been at their lowest rate for quite a number of years. That is reflected in the fact that we do not talk about MRSA very much any more whereas we used to when it was an enormous problem years ago. It still is a problem but not to the extent it was.

We have more day surgery than ever before. We have reduced the length of stay. People who go to hospital are spending less time in hospital. To give the committee one example of that, people who go to hospital with chronic obstructive pulmonary disease, COPD, which in the old days was bronchitis or emphysema, used to spend on average nine days in the hospital. They now spend about seven and a half days in hospital because they can be discharged to the community and have nurses visit them initially after discharge and check on their care.

Notwithstanding the marked deterioration that has occurred in recent months, waiting times and trolley numbers are still better than they were in 2011, when the Government changed.

We have the air ambulance, which is a huge improvement, especially for the west and the midlands, in getting people to hospital quickly. That did not exist in the past.

We have a very good story to tell on transplants. Ireland is moving up the league table in terms of transplants done. Today, Ireland will perform its 100th lung transplant in the Mater hospital. I want to recognise the CEO of the hospital, Professor Mary Day, and also the director of organ donation there, Professor Jim Egan, for the work they do. In a country with very high levels of cystic fibrosis, in particular, having a lung transplant programme is very important. Similarly, when it comes to renal disease and kidneys, we are one of the few countries in the world that has more people who have had a kidney transplant than are on dialysis. That is a remarkable achievement.

Also, and it is the final good thing I am going to talk about before I talk about all the bad things, we are seeing real improvements in patient transfer, for example, in getting patients from a smaller or regional hospital to a national centre. When I was a junior doctor, if I had to transfer a patient from Navan to Dublin, for example, I would go in the ambulance. I would be a rather junior doctor, not very experienced, but I would be going with the patient, probably for several hours, to get the patient from Navan to the Mater or wherever they were going, and then I would go back in the ambulance or by taxi. Not only did that mean the patient had a relatively junior doctor travelling with him or her, it also meant the hospital was down a doctor for half the day. That was quite a dangerous thing, particularly on a Saturday, Sunday or bank holiday. The hospital could be run by one or two doctors for the best part of a day. With neonates and paediatrics, that is no longer the case. Last week, a new paediatric transfer service was put into place. If a child is being transferred from a regional hospital to one of the two national centres, there is now a dedicated team whose main job is to go in the ambulance, pick up the child, provide them with the care they need from the moment they get into the ambulance, and take that child to the national centre. At no point is any hospital denuded of their core staff because a patient needs to be transferred.

Dare I say it, those are ten examples of how the health service has improved since the days when I worked in it.

It is just over 100 days since I was appointed Minister for Health. On my appointment, I said my first priority was a realistic budget and I believe we achieved that with our budget allocation in 2015, which has an increase in the exchequer allocation of more than €300 million when compared with the 2014 allocation and more than €500 million when compared with the ceiling that had been planned for 2015. Alongside the increase in this allocation, we have also identified one-off additional income measures of €330 million and savings of a further €130 million in procurement, medicine and agency staff . Combined, this means the HSE has in excess of €750 million more to fund services than it did when it was preparing its 2014 service plan, roughly this time last year.

The cycle of cuts in health care has come to an end. As I said on the night of the budget, we have secured a welcome but modest increase in the total financial resources available to the HSE, which is for the first time in seven years.