Simon Harris (Wicklow, Fine Gael) | Oireachtas source

This year it is no longer acceptable to say that the HSE is not adequately funded. I say that because the Director General of the HSE, when he launched the service plan with me, said that the service plan was adequately funded for the delivery of the targets within it. There is recognition from the HSE that the Houses of the Oireachtas have provided adequate funding to deliver on the priorities in the service plan. In this year's service plan we have tried to prioritise some of the areas that have caused particular difficulty to our patients, our citizens and our staff in recent years. I spoke about earlier about the situation in previous years where children with disabilities were turning 18 in the summer but there was a lack of funding for an adequate transition place. This year, costs for school leavers have been factored into the service plan. There have been significant increases in home care and home care packages.

In regard to medical cards, where in the past there were significant challenges, in particular during the years of recession, today I will publish the Bill. I will try and get the legislation through the Houses of the Oireachtas as quickly as possible to ensure that every child with a disability whose parent is in receipt of domiciliary carer's allowance will have an automatic entitlement to a medical card. That is about 33,000 children in this country. Of the 33,000, almost 10,000 of them do not have a medical card today. The others are subject to reviews, which can cause a lot of distress and hassle and inconvenience for a family when the condition, in all likelihood, will not have changed, or certainly will not have improved.

We are now back to investing in waiting list initiatives. I will not suggest that in one year of doing so we will be able to deal with the totality of the waiting list problem. However, we will unapologetically target those waiting the longest. If the Deputy went to the doctor today and needed a hospital procedure or hospital appointment, he would go on a waiting list. What matters is how long one is on that waiting list. That we have people waiting 18 months and longer for procedures and that we have children waiting such a long period of time is not acceptable. That is why all of our efforts in regard to waiting lists will be targeted at the longest waiters. If waiting times can be reduced this year and that work is built on in following years, it will be possible to get back to the relatively good waiting list times which this country previously had.

Emergency department overcrowding is perhaps the biggest challenge. It is dependent on a number of factors. One is bed capacity. Another is staffing. A bit like Deputy Kelleher's question, another factor is to what extent we are currently providing services in acute hospitals which can be provided outside that, be it in primary care, through a GP contract, more primary care teams, community intervention teams or supporting our nursing homes to do more.

Usually the winter initiative comes to an end around now. I came into office in May. Discussions started during the summer about a winter initiative which was to take effect in September or October. This month I intend to begin having conversations about the winter initiative for 2017. I have asked the HSE and the Department to get together and do a look back and a look forward. They will examine what went well and what worked. For example, we had the lowest level of delayed discharges ever recorded. Some things clearly did not go well. We will then analyse that data and try to understand, for example, what were the reasons for significant increases on certain days. If we had GP out-of-hours for a greater length, would that have reduced the attendances? We must ensure the measures are targeted. I would welcome a conversation with this committee before the summer in regard to the preparedness for winter next year. If we follow those steps, we can reasonably take all steps possible.