Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I welcome the Minister and his officials. One of the terms of reference of the committee is the need to establish a universal, single-tier health service where patients are treated on the basis of need rather than ability to pay. I do not see how that fits with what the Minister says with regard to performance incentives and his heavy duty reference to the private sector. It appears that the Minister is alluding to continuing with the status quo. While we are examining a universal, single-tier health service that is available when people need it, the Minister is talking about private health insurance and private patients in public hospitals. That is a concern. As I have told the Minister on a number of occasions, I believe that while we are working in this committee and doing our best to produce a good report that will inform policy and strategy for the future, the Government and officials in the Department are busy undermining and undoing any potential we have for success. Nothing in the Minister's statement gives me a reason to change my mind. It is disappointing that we all read much of what was in his statement in the newspapers at the weekend and earlier this week. However, I suppose that is par for the course.

With regard to the reference to the organisational reform of organisations that the Minister acknowledges are suffering from reform fatigue, does he envisage a devolution of power to ward level? I am referring to giving local clinicians and local managers the capacity and ability to recruit their own staff. Under the current system, it is very difficult to recruit staff because the power does not rest in the hands of the people who should be making the decision. Perhaps the Minister would elaborate on the continuation of the public and private mix and on whether, in future, he envisages allowing the clinicians and front-line staff to have the power to recruit their own staff. Without that and for as long as we maintain the current system we will continue to lose staff at a rate of knots and not recruit the staff to replace them.