Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Definitely not, God almighty. In any event, he said, "Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community." No matter how many times certain people try to tell the people of this good country that I have a given view that I do not have, that comment represents my view. That is the view to which my party, the Government, the Opposition and all parties in the House have signed up. We want to get to a point of universal health care based on need. However, I have a duty to put it to any member of the committee who may become Minister for Health that he or she is going to have to find out what to do with the shortfall following any decision to the effect that private income would go from the hospitals.

I want to move towards a place where our citizens do not believe they need private health insurance. However, we are a long way from that. It would amount to blowing a €700 million hole in the health service budget were we to get rid of that private income.

People should not try to misrepresent my views at what is a cross-party committee. I am here in good faith. People should not try to misrepresent my views in a partisan sense. Deputy O'Reilly may be trying to create an ideological war. I believe in universal health care. Deputy O'Reilly can keep telling people that I do not, but that is my belief and that is what I want to deliver.

I also have a duty in this role to inform the committee of the complexities of arriving at that point. We have to address that in the report of the committee and in my consideration of how we work together. That is why it is right and proper, in fairness to the Chairman and the committee, to look at the ten-year horizon, because we cannot get from point A to point B immediately. It is a question of how we sequence arriving at that point. That is the challenge for all of us.

Reference was made to reform fatigue. The major reason people have reform fatigue is that they have seen a great deal of time spent on structural reform without many benefits for patients. It seems reform has been more about the structures and the systems rather than the patients. Therefore, any structural reform we undertake has to be stress-tested against the question of whether it will make a difference to patients. I genuinely believe that by removing layers in between the patients and the care they receive today, for example, the duplication of management structures between community health care organisations and hospital groups, we can improve things.

Reference was made to recruitment, delegated sanction, localising the process and empowering people. As committee members will be aware, we have localised the ability to recruit nurses through delegated sanction at director of nursing level in hospitals. This is based on a view that the INMO and SIPTU put to me. They made the point that it is all well and good for me or committee members or anyone else to say we are going to hire 1,200 new nurses this year, but when they staff go back to the hospitals they find great difficulty in doing that. We have delegated sanction to the director of nursing for 2017. It will be interesting to see how that works during the year. We have given a level of autonomy that they have not had before now.