Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I would imagine many of them are replacement posts. I will revert to the Deputy on that.

With regard to e-health, I am really pleased to hear the Deputy say what she is saying. There has been a tendency in this country, and perhaps in others, to be dismissive of investments in technology and ICT and to ask why all the money is being spent on computers. This investment is vital. The National Treatment Purchase Fund publishes its waiting list figures every month. While we can all agree the lists are far too long, none of us, including me, can delve down into the detail to the extent that we can determine how many times Mrs. Murphy is on a waiting list and how many doctors she has been referred to. That level of detail is needed to make informed policy decisions. We will have €50 million for a waiting list initiative under the commitment in the programme for Government. How best can we direct that?

I was taken by the Deputy's view on the Portuguese model. I have asked that it be considered in the context of the technology being developed in respect of waiting list initiatives. I would be happy to engage with the Deputy further on that. There has been historic under-investment in this country on ICT. We are seeing a new dawn regarding the work of the chief information officer and the e-health agenda. There is a lot of good work taking place in this area. By this time next year, every one of us will have an individual health identifier, IHI, whereby, for the first time, we will be individually recognised by the health service. This is really important.

I am also considering using technology for basic tasks. Some 15% of people on waiting lists are not attending their appointments. My saying this is not blaming the patient. If one is waiting a year for an appointment, one might forget about it. It is not unreasonable for this to happen. We should consider how we can do simple things with ICT, such as reminding people about their appointments using SMS. Obviously, the do-not-attend figure results in a huge cost to the health service. It is much higher than it should be. I agree with the Deputy in this regard. In the service plan and the budgetary process, I want to see progress on the health investment levels. I hope the Deputy will see this reflected in my plans in the coming weeks.

Before I refer to the question of new medicines, I will refer to Councillor Treacy. I had an opportunity to have a brief conversation with her when we met in RTE recently. She has done superb work on highlighting an important issue. I recently met representatives of An Saol, which is doing considerable work highlighting the really complex needs of their loved ones. They have an absolutely understandable desire that the State, the health service, provide more than just somewhere for loved ones to reside and instead provide an opportunity so those loved ones can live their lives to their full potential. Very interestingly, the proposals the An Saol representatives made to me in my conversation with them were based on the better use of the resources already being provided to their loved ones. It is proposed that, instead of putting an individual in his or her thirties into a nursing home, one could actually reallocate the funding. This is actively being considered. An Saol has recently engaged with the HSE on this. I am to meet Councillor Treacy shortly. There is a date in our diaries. I look forward to seeing what we can do to assist on the broad issue she has been highlighting.

As the Deputy says, there is a strategy in regard to all this. An implementation plan is due to be published this year. This is where we need to get to, so we can align with our implementation plan the views of all the campaigning groups that have highlighted deficiencies in this area. I look forward to the opportunity for Councillor Treacy, An Saol and other groups to feed into this process. Senator Kelleher has a keen interest in this and we have engaged on it.

With regard to the criteria and new drugs, the criteria are obviously the health needs of the public, the cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services, and the availability and suitability of items for supplier reimbursement. Nine criteria are listed. They are outlined in the Act of 2013 and they are not listed in order of priority. The challenge for the HSE is to balance all those competing criteria. At times, they do compete. The list of criteria needs to be considered.

The HSE leadership team comprises the directorate and also the HSE drugs group, which comprises clinicians. Within days of coming into office, I was being contacted by people saying that if I did not provide such a drug, certain men or women would die. That is not a decision I am qualified to make. It is not a decision that any of us as politicians should be making. What we have tried to do, therefore, is evident in the new agreement. There has been progress made in this regard although the process is still far from ideal. We need to examine what other countries are doing in this regard. What we have tried to do is put in place a very clear set of criteria. These criteria are to be considered by a HSE drugs group, comprising a group of clinicians. It is the decision of this group to go to the HSE leadership team. Ultimately, recourse to the Government will still be needed should there be a funding requirement above and beyond the funding available to the HSE.

I am going to Bratislava shortly to an EU health Ministers' meeting. I want to engage with colleagues on what other countries do because I believe there has to be a better way of doing this. Bearing in mind that many of us in this room will be Ministers on some occasions in our careers, I do not believe any of us want to find ourselves in a position in which the Cabinet or individual Ministers are playing God. It is not desirable.

A very useful part of the agreement concerns looking forward, or the scanning exercise that will be carried out annually between the Department, the HSE and the industry. In advance of the Estimates process next year, rather than this year, people will sit down to consider the pipeline of drugs. That would better enable me, or whoever is in this role, to determine how funding might be put aside for the three, four, five or many more drugs that are coming down the tracks. Currently, we can be taken by surprise somewhat. Of course, we all want our loved ones to have access to a new drug that becomes available. We must currently scramble somewhat to assemble facts, so scanning ahead for 12 months is a better system.