Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I will be kind. I apologise for being absent twice during the meeting. If there is no time to answer my questions this evening, I will be happy to accept a written reply.

Is there a trouble-shooter in the system who monitors the capacity to deal with unforeseen accidents or emergencies that arise at any location throughout the country? We did that many moons ago when I was a member of the health board. We did practice drills that showed up any inadequacies and showed management if there was capacity and capability.

The Minister mentioned the word capacity which we became very familiar with in the course of the meetings of the Committee on the Future of Healthcare. As I said before, I believe we can work out all these things mathematically. We can identify the extent of a deficiency in any area. We can identify where it is at and how to counter it. To what extent, if at all, has that concept been employed by the HSE to identify a lack of capacity in certain areas whether it is hospital beds, nursing staff, doctors, consultants or any other aspect of the service? It is only when the service is tested that its weakest point shows up. It is that which determines what is the service.

I will comment on the unattractiveness of GP practices in city and country at present. There is an ongoing negative attitude in the commentary on health services and it is unhelpful. Nobody wants to go to work in a place that has an aura of negativity hanging over it. They do not want to be victims, and rightly so, of the general criticism of the system. We have to improve the system but, on the other hand, we have to be conscious that people who work in a particular situation at any given time like to feel they are doing a job that is appreciated. An issue that comes up from time to time is quality of life in the workplace and job satisfaction. If one removed that from the delivery of vital services such as the health services, there would be a serious void which would show up to a greater extent.

Home care packages have already been mentioned so I will not go over it again. There is a case which has received publicity in the past number of days. I compliment those who dealt with the issue when it became a national issue and an emergency issue. Capacity needs to be put in place within the system to deal with the human elements that arise from time to time for which there is no set piece on paper. There is no tabular form that can be referred to. There is a necessity to be able to take the situation and deal with it. That applies to medical cards too, which is an area in which it is improving. It does not only apply to health services; it applies to all services throughout the country. That is the way it is.

Drug costs have been referred to already. I compliment the Minister on his work so far in experimental drugs. I do not know if we can resolve it permanently or not. I am strongly of the view that the Single Market should apply in this as it does in everything else. If one is ordering a product on behalf of 500 million people, one certainly has greater clout than if one is ordering it on behalf of 5 million people. I would ask that special emphasis be put on bringing it to the fore as soon as possible.

I have two final points. The first is on orthodontics. It is something that causes awful problems in households and huge expense. Parents go to the ends of the earth to borrow money to carry out orthodontics. We have a system of category one, category two and category three. Category three patients never get treated at all. Category one patients get treated on a long ongoing basis. It is not a satisfactory system. Will somebody please identify what the problems are and try to deal with them in a way that is more dependable and efficient and which reflects a modern society?

The last point I will make is on the disability sector. I compliment the Minister and Ministers of State on their reappointment and new Ministers of State on their appointment. I wish those who have moved on to other places the very best. Mid-term reviews are always difficult times. It is good to see people back in the roles they have become familiar with. I have always held the view that if one has an agenda in a Government Department, one has to bring it forward. If it is a five-year plan, one better bring it forward to six months because it will take five years to implement the six-month plan. What is the extent to which adequate resources remain available to the Department and the Minister to cater for the transport needs, day care, respite care and residential needs which seem to be merging to a greater extent now? I have spoken about it before, as has everybody else.

The same people are carrying the burden for many years. They get tired and worried. We do not always respond in the way that we should, but follow a blueprint that seems to have the answer, but does not always work out that way. The blueprint can work to the detriment of Ministers as well, as they will be informed of the prototype, which is usually trotted out to diffuse the Minister's concern and anxiety about the lack of progress or whatever the case may be, but we need to come to grips with this in so far as we can.

In response to the point on social media and the vaccination inoculation programme, yes, serious damage has been done to the vaccination programme on social media. The problem is that public representatives have to ask themselves if the points made on social media are accurate. It takes time before there is a rebuttal. My advice is that there is no point responding in the newspapers such as the The Times or The Sunday Timesto a point made on social media. One must respond to it through social media. Otherwise public confidence in the health system will be eroded, and it will be eroded before the Minister or Minister of State has had time to get to grips with the situation.