Rose Conway Walsh (Sinn Fein) | Oireachtas source

I thank the Minister. I commend the great work done in bringing to fruition the new primary care centre in Castlebar. It is fantastic. However, it is 17 years late. One of the pilot projects under the original primary care strategy was in County Mayo. However, the projects were never invested in or developed in the way envisaged. Seventeen years later we have the centre in Castlebar which we do welcome.

What worries me a little is that when the Minister goes to some of the primary care centres, he gets all of the good news and hears examples of good practice, rightly so. That is appropriate as it is important to mainstream good practice mentioned to the Minister in all of his visits, but he is not necessarily told that there are hundreds of children in County Mayo, for example, waiting for physiotherapy. People wait for physiotherapy throughout life because we do not have nearly enough physiotherapists or occupational therapists. Bearing in mind the needs associated with long-term illness and maternity care, for example, this issue is not being addressed in a proper way. Sometimes it can be covered up. This speaks to the number of parliamentary questions the Minister is being asked. That they have to be asked in the first place is a waste of resources. There are many things being covered up that should be transparent.

I wish to concentrate a little on the programme on the HSE shown last night. It begs the question as to whether RTÉ is responsible for running the health service. We owe a debt to people such as Ms Oonagh Smyth and others who bring these concerns to the fore. It is extremely worrying that 43,500 public patients have been displaced because of what is happening within the system. Private patients are receiving preference over them and those affected have lost out in the past two years.

What has been lost as a result of the 2008 contracts not being fulfilled? Has the Department estimated the cost to the public system? Are there sanctions to be implemented? Have they ever been implemented against the consultants who clearly broke their contracts? If we do not have sanctions, we will not produce the behaviour required. Was the Minister surprised by last night's programme or did he have all of the information already? Why did the HSE stop compiling the compliance data for private practice limits within public hospitals? Did it ask the Minister for permission to do this? Sometimes it is very difficult for people to know what the relationship is between the HSE, the Minister and the Department and where responsibility lies. It seems that the Minister has all of the responsibility and that the HSE has all of the authority in terms of implementation. Did the Minister stop the compilation of data in 2014?

The strategy is very good. The Minister's way of encompassing all political parties, albeit with limitations, is good. It gives me some confidence. I must, however, look back to 2002 when Fianna Fáil was following its ten-year strategy, the aim of which was to deliver high quality health care for all. The distinction between the public and private systems, however, was still to remain under its strategy, but it stated there would be greater equity for public patients and that this would be sought in the revised contract to come about in 2008. The current strategy, like the Fianna Fáil strategy which was an absolute failure, no more than A Vision for Change which was never supported or implemented in the way it should have been, will be judged by the hundreds of thousands waiting for appointments, those waiting for physiotherapy and occupational therapy in County Mayo and those waiting months for counselling, the waiting period for which is very worrying. If a young person in County Mayo presents for counselling today through the primary care counselling system, he or she may have to wait for many months. I have experience of working with it all the time on the ground.

I welcome the allocation in the budget for extra home help hours. However, the Minister will know that it was only to address part of the existing waiting list. It is not a matter of home help care hours anymore but home health care minutes, which is wrong. If the Minister was to underpin the strategy and take immediate action, even by addressing the issue of home health care minutes by offering a minimum period of one hour, it would solve many of the problems. People could be assured of having one hour rather than minutes. There are other practical steps that could be taken in the meantime.

I wonder how much it cost to devise the Saolta system, even in terms of branding and logos. Does the Minister have a figure for it?

Education and training are key to tackling these issues in the longer term. There are models of good practice elsewhere. What relationship does the Minister have with the Department of Education and Skills? There are young people I know who would make fantastic doctors but who cannot obtain the points required or get through the quagmire of barriers they face in the education system. I would like to see some movement in that regard. We absolutely need to see it. There could be a relationship whereby, even through funding models, a young person would be compelled to work within the Irish system for a certain number of years. Until we tackle this issue, we will continue to have problems. In all of this, I am conscious of the challenges that arise in the recruitment of clinicians across the board.

I would appreciate it if the Minister answered those few questions.