Alan Kelly (Tipperary, Labour) | Oireachtas source

I thank the Minister for his comprehensive statement. This group is working to try to take the politics out of health and to deliver for years to come. The Minister is the sitting prince, for the want of a better phrase, and so we have to put questions to him as the person who holds the mantle at the moment, even though this will transcend his period in office.

This is a moving target. Things will change. Technology will change. Needs will change. Standards of living will change. Everything will change. What we put in place will have to be adaptable for the future. There is no such thing as best practice. There is practice and there are circumstances. It is a question of how we implement it. We have to be able to tailor it. My question is as much for Mr. Breslin as for the Minister. In any event, does the Minister believe that there is capacity in the Department of Health and the current structure of the HSE to do these things? Does the Minister believe there is the capacity, including the intellectual capacity, dare I say it, the will or the drive to do these things? It is not a personal thing; it is a real request.

We all know the HSE has to change. The Minister referred to dismantling and a leaner system etc. I agree with the Minister's comments on alignment. However, I am concerned that any decisions that might be made may impact on what we are going to deliver. I appeal to the Minister to bear that in mind.

I agree with the Minister on a range of issues relating to primary care, capacity, etc. However, we are stuck for time so I will fire on with my questions. The Minister is currently in discussions with the general practitioners - as well as consultants - regarding contracts. The Minister referred to activity-based funding. That is an interesting thing and if we have more time, we will get into it. I have real concerns here. These are central issues. If any advancement in these areas is made that is contrary to what we come up with, then we could have be a real issue. We need close alignment. We are aiming to head towards a single tier universal health service based on need. Any potential commitments made to either of the groups I have referred to would certainly impact on that. Will the Minister bear that in mind?

Reference was made to the capital programme. We know what we have to do in terms of capacity. We know that we have to improve it. I agree with the Minister regarding alignment. There will be decisions on the capital plan but there is a cross-over in terms of the work of this committee. We have to be careful that decisions are not made from which we cannot row back.

Reference was made to case-based charging in the insurance area. That is an interesting concept and I would like to have more time to go through it. Will the Minister elaborate on his vision as the sitting prince? What does the Minister mean by that? How would it work? I am somewhat nervous in respect of going down this road about how it would actually work.

There are two areas where we cannot wait for this committee. I would be happy for the Minister to advance these areas. Ever since PPARS and every other information technology disaster that has arisen over the past 15 years, there has been no capital expenditure for e-health. From a technology point of view, the situation for health care is a joke. I hope the Minister will advance that matter.