Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I thank everyone for their contributions. There is a general theme running through all of them and there is a lot of enthusiasm and ambition for the health service in the room. Perhaps our fault as politicians over the years has been that we have been fatalistic about the health service and that there was a sense that it was a hopeless case. However, I very much get a sense that people here want to work very hard to achieve a better health system. We know that most other countries, certainly most other European countries, have good, functioning health services where it is unheard of that a person would have to wait 15 months or two years for an appointment with a specialist. Services are accessible when they are needed, irrespective of means. I think that is the aim for all of us.

There is a strong level of ambition and an open-mindedness in the committee to look at the evidence, leave the politics aside and do what a number of members spoke about, which is putting the focus on the patient. Often within the health service, the patient is forgotten because there are so many other interests. At a ministerial level, in particular, this is something one would be conscious of. There are some powerful lobbying groups within the health service and sometimes it is hard to get through the fog of all of that and keep the focus on the patient. That is probably the single most important message coming from the contributions this morning, which is the need to keep the focus on the patient and to do what is in best interests of the patient.

The ten-year plan has been mentioned and a few people outside the committee have been commenting on it.

We have to make it clear that we are not talking about doing work for something that can be achieved in ten years' time. It is about agreeing the kind of health system that we need in this country, the funding model for it and how we start to transition later this year and early next year over a ten-year period, which is a reasonable perspective in terms of system change, but we have to be clear about the phasing of it.

The problem we have had to date is that every time there is a new Government or a new Minister there is a new plan. With each change of plan, there is huge disruption caused to the health service and a huge lack of certainty about what the future holds. We have to bring that to an end. We can learn a lot from what happened in the UK after the war where the two big parties in the UK, coming from very different places, agreed on the NHS model. Irrespective of which party was in government, everyone supported that model. Notwithstanding some of the problems that have arisen over the years, by and large there is huge buy-in to that approach and the British people are very proud of their health service. We need to get to that point, which is an agreement on the system and the model and, irrespective of what parties are in government, we can support, fund and stick to the model for the future.

The order to take is probably to agree the type of system, then the funding model and then the model of care. There are lots of examples of models of care including the switch to primary care in terms of pharmacists, GPs, allied health professionals and so on providing services locally in the community thereby saving the patients the need to go to acute hospitals and taking the burden off acute services. There are lots of models and all of them have to be considered in the context of the overall system and the funding system, which determines in practical terms the types of models we have.

There have been many good suggestions. On Deputy Daly's point about getting advice on strategy, we probably need to get advice on the project management aspect. We will examine the matter and perhaps we will have a chance to speak about it later. The other suggestion was that we would get an initial presentation on the current system, the different types of health systems, particularly those which are common in Europe, and the different issues in respect of funding models. In that regard, I suggest we bring in representatives from the ESRI to give us that overview at our next meeting. A lot of academic work has been carried out by the ESRI over recent years. Specifically, last year it did the costings for Government on the proposals for universal health insurance, which was subsequently dropped. It has looked at different types of health systems and the funding models involved. I suggest that we get those representatives in at an early stage to give us that kind of overview and context.

We also need to consider the best time and how frequently we should meet. How do members feel about us having weekly meetings until the end of July? Is that possible? Can we do that? Yes.