Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I circulated the speech to members yesterday afternoon.

I agree with Deputy Barry on the need to create a stronger public health service. One reason health has been a partisan political issue for many years is it has suited many of us to exaggerate our differences on health. The overwhelming majority of people in this House, and I am one, want to see universal health care that can provide on the basis of need rather than ability to pay. The Deputy and I probably have different views on how we arrive at that point. I think we arrive at it by building the capacity in the public sector and convincing people that they can rely on the public service. It is possible to take out private health insurance in the UK but very few choose to do that. I do not see us outlawing private health insurance or private hospitals. As we improve the health service people will begin to move. The National Health Service, NHS, is far from perfect. We should also consider the headlines in the British press about its financial sustainability, recruitment and retention of professionals and see that it has similar problems. We should not hold up the NHS as a model but it is available as a founding principle for universal health care. I am wary of suggesting, as my party has done in the past, that we can go to any country and lift its health policy to use here. We need to have an Irish version of the system.

I agree with Deputy Brassil about governance. I will need a parliamentary majority to embark on a ten-year strategy and deliver universal health care. We should be embarking very quickly on a Bill to improve the governance structures of the current HSE while on that journey. If we can muster a majority and if the committee has views on what that structure might look like I would like to move ahead with it urgently. That would address some of the issues outlined in terms of making sure that my views, those of the committee and the Department can be properly conveyed to the HSE. The director general of the HSE has stated publicly there is a shared frustration at the current governance arrangements. That should be one of the first things we set about doing, as an interim measure.

The Deputy is dead right about the Department versus a national agency. The concern is that if it is subsumed back into the Department, it returns to the political realm. As for how much politics has been taken out of health care since the establishment of the HSE, in truth many of the issues I am asked about are operational matters. It is questionable how much has actually been removed. It is a legitimate point and that is why I have kept an open mind on it. I am very clear that the national element of the health service needs to be much slimmer and leaner. I am open to persuasion by this committee on its location as a stand-alone agency or within the Department.