Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I would not either, but a lot of people in this country hold up the NHS as marking the point to which we want to get. In that context, I make the point that there is a significant turnover of managers in the NHS. We are in a situation where we need to develop management within the health service and hospitals. I sometimes get into trouble for saying this, but the truth is that where there are good management structures in place in hospitals, we perform better than where we do not. I was in one the other day which shall remain nameless. There had been a change in a number of personnel and there was a lot of new energy in the place and the metrics were very much moving in the right direction. We need to support good management. We also need to recruit good managers. We need to consider holdindg more international competitions. We recently hired two deputy director generals for the HSE through an open international competition.

I thank Senator John Dolan for his comments on other members of the Government having a role in this regard, which they do. A lot of what is contained in the Sláintecare report and what the Senator talked about is preventative. It is concerned with having a healthy society and people not getting sick in the first place. I have a role to play in that regard but so too does education, as well as a lot of elements of the health service. Issues such as poverty are also relevant. The Senator's advice is wise in avoiding what he described as old viruses in the system. This is not the first time people have tried to reform the health service, but this time there are differences. The all-party approach is a big one. I also take the Senator's point about going beyond structural change, which is also a risk. If in a year's time the public sees that all we are doing is talking about structural change, the view will be "here they go again." I believe structures need to be changed for all of the reasons outlined by the Sláintecare committee. There is too much centralisation; there is no proper governance and there are lots of changes we have to make. However, in doing so we also have to try to have tangible wins for the people in order that they can see the benefits.