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

I welcome Mr. Horan and join Senator Colm Burke in wishing him well in his new appointment. That said, I have serious ideological difficulties with the National Treatment Purchase Fund and the privatisation of the health service by stealth, as well as public money being siphoned off and given directly to the private sector. However, this does not in any way prevent me from wishing Mr. Horan well in his new role.

I will cite statements made about the National Treatment Purchase Fund by several people who are much more qualified than I am to speak about it. Professor Louise Kenny stated:

The NTPF does not build long-term sustainability ... The NTPF in its current format is not a solution to addressing waiting lists across the board.

Dr. Peter Boylan stated:

The NTPF is a bad idea ... It is just bad clinical practice and it should be abandoned.

It is a bit counter-intuitive to expect that handing money to private sector will somehow magically improve the public service. It never will. The former acting chief executive officer of the NTPF was forthright in his opinion that the private sector was much more efficient. Members of this committee and the witnesses know that is because scheduled and elective procedures will always be cheaper than running an emergency department or a public hospital where all comers are treated. A significant amount of money can be saved if one can cherry-pick, but that option is not available to the public system. What are Mr. Horan's views on the performance of the public versus the private sector? I note from his curriculum vitae that he has experience in both sectors and that he served on the public services of the Irish Congress of Trade Unions, as did I, and on the Employment Appeals Tribunal, as did a close member of my family. In view of his experience, I am interested in his views on the performance of the public versus the private sector.

The witness also discussed the issue of insourcing. There is a very small amount of money put aside for that. Sinn Féin has long promoted a policy for a single integrated waiting list management system which it calls Comhliosta. Officials in the NTPF are examining this possibility but only on a hospital group basis. What are the witness's views on the nationwide expansion of such a system? If insourcing is to be focused upon, as should be done, and if money is to be put into the public service rather than fund the profits of large multinational private sector organisations, as should be done, it should be on a national basis.

With regard to the commissioning of beds or the negotiation and purchasing of beds in private nursing homes, in Scotland, large sections of nursing homes are leased for public use. Deputy Harty and I met the Scottish Cabinet Secretary for Health and Sport, Shona Robison, who said it is a very cost-effective model. If there must be privatisation in that sector, it would be important to get the best value for money for the Exchequer. The Scottish scheme proved very effective and did away with tensions in terms of nursing homes for residents, management and workers. We do not want a situation where nursing homes begin undercutting each other on price as that would impact on workers and residents. No one wants to see that. There has to be a fairer way of getting value for money for the Exchequer. What are the witness's views in this regard?

Sláintecare, the report of the Committee on the Future of Healthcare, was launched yesterday. The committee made ambitious plans as part of that report. One key principle agreed upon by the committee is that public money should only be spent in the public interest. The witness is aware of my views in this regard. How will handing money to the private sector so that large and small corporations can make a profit from treating patients fit with the future vision of the health service and how will the NTPF fit in, in view of there being cross-party agreement on a vision which does not tally with the work of the NTPF? I am open to correction or persuasion on this matter and I am interested to hear the witness's views.