Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

We need to be wise to the threats to our economic recovery and stability. It is very easy and tempting to assume that the economy is now fixed and that we do not need to be concerned with it any longer and that we should move on to other problems. I do not know how many times in our history we have made that mistake only for the economy to become unstuck again and fall back into the cycle of cutbacks and tax increases. We do not want that to happen ever again. There are risks out there. I have already mentioned our high public debt, which is among the highest in the western world when it is divided per person. We need to use this opportunity, while the economy is growing, to balance the budget, perhaps even run small surpluses, and get the debt down so that we are ready for the next downturn, whenever it comes. It might be ten or 20 years away, but it will come inevitably. We have to make sure we have the capacity to provide for borrowing when the next recession comes.

Brexit is another factor. It could be soft and slow or hard and chaotic. It is a big potential risk for our economy. Other risk factors include rising interest rates. Huge numbers of people in Ireland have quite expensive mortgages, in terms of the business of loans. We have had a cycle of unusually low interest rates for quite some time now. It is inevitable that at some point in the next number of years the ECB will increase interest rates, which will increase the cost of borrowing for businesses and the cost of mortgages. It will have an impact on how much money is available to spend in the economy. We have to be wise to all of those things and make sure we do not repeat the mistakes of the past. We cannot engage in pro-cyclical economic policies or adopt the attitude of "when I have it I spend it", because when that attitude is adopted one quickly does not have money to spend. Anything we do in terms of tax cuts, spending increases, pay increases or increases in spending for public expenditure should be sustainable. There is no point in providing pay increases or tax cuts, or increasing funding for services, only to take that money back in two or three years. I believe most people would prefer a steady, reliable trajectory than the alternative, which we have experienced a great deal of in recent years.

The Sláintecare report is very good. I read it again a couple of weeks ago, alongside the draft of the implementation plan, which exists and which the Government is discussing. We anticipate that it will be published within the next two months, well before the summer recess. I do not believe it is correct to see it as a comprehensive action plan to transform our health services. It certainly has its limitations. It is more like a blueprint, a plan for a plan rather than a plan in itself. A number of things have been done towards its implementation already. The de Buitléir group has been set up to examine the issue of separating public and private practice, how much it would cost and how it could be done. Again, the report does not provide any solutions. It just tells us that we should examine it, and that is exactly what we are doing.

We have also established the implementation office. We are in the process of appointing the executive director for the Sláintecare implementation office. This is likely to be concluded within weeks, and we will publish the implementation plan around the same time so that the executive director will have a plan to implement. That plan of action makes sense to me. The recommendation of Sláintecare is to more or less retain the HSE but to slim it down and restore its board. The Minister has accepted those recommendations and will bring forward that legislation in the next couple of months. We have also taken steps to reduce prescription charges and increase the number of people with access to free GP care, which are recommendations in the report. Although we have not published the implementation plan as yet we have taken some measures toward implementing the report. Another is the allocation of over €10 billion over the next ten years towards investment in ICT, equipment and buildings. That is part of the transformation fund that the Sláintecare report advocates.

There are some things we have to be very careful about doing. One of the recommendations in the Sláintecare report is that we front-load reducing the cost of access before increasing capacity, that we prioritise making things free before increasing the capacity to deal with patients. I am not sure that is the correct approach. I would be concerned that, if we made everything free in the first instance, the health system might be overwhelmed. Sláintecare recommends that the number of people availing of free GP care should be increased by 250,000 a year. That would mean 250,000 this year, 500,000 next year, and 750,000 within three years. Do we really believe our GPs could cope with another 750,000 people with free GP care? We are aware of the increase in attendances that came about with the removal of fees for children under six. We have to be sensible about how we phase the implementation, and we also have to work out the costings, which has been a real dilemma. We know, because our health service is inefficient at the moment, that it is costing us almost 7% extra a year just to stand still. That amounts to €700 million a year just so that we can stand still. If we go above that it will mean enormous costs.

One of the great advantages of the all-party committees is that they give us all-party reports. We had reports on housing, water and in healthcare. However, one of the downsides is that issues are looked at in isolation. Housing reports would have the Government invest all the State resources in housing and leave nothing for health. Health reports would have the Government invest all of the resource of the State in health and leave nothing for housing, never mind disability, education or anything else. We have to look at the bigger picture and consider all the different reports, and try to sequence them in a way that is affordable and deliverable. The all-party approach only looks at issues in isolation and does not understand the impact of implementing those decisions on every other matter of concern and public policy.

On the non-performing loans, whatever happens, the Government, in both its capacity as the Government and as a shareholder, has to be on the side of people who are making an honest effort to pay their mortgages, including split mortgages. All of those with a split mortgage are making a serious effort to pay their mortgage. Where people are not making genuine efforts to pay what they owe that is a different matter. We have vacant houses owned by people who are not paying the mortgage any more, some of who no longer live in the country. Those houses should be brought back into use. In some cases repossession will be necessary. We need to make a real distinction between those who are making a genuine effort to pay the mortgages, the money they owe, and those who are not.