Michael Harty (Clare, Independent) | Oireachtas source

I will call Senator Colm Burke in a moment.

I wish to return to the global issues. The Committee on the Future of Healthcare sat for 11 months and produced the Sláintecare report. While the Sláintecare report is viewed differently by different organisations, it was a cross-party report looking at the future of healthcare and offering a ten-year vision for the healthcare system. The Government has yet to respond to many of the recommendations in the Sláintecare report, 400 days after it was published. Every month it claims its response is imminent. I understand that the costings for Sláintecare have been challenged and that it has gone to the Department of Public Expenditure and Reform for review. Many of the Sláintecare report recommendations would not prove very costly because it recommends a change in the model of care, in the system and within the HSE.

I would like Mr. Varley to comment on one of the recommendations in particular. I refer to that relating to the separation of private care within the public hospital system. The argument is that if that private money is taken out of the system, the system will collapse. We are saying that we expect the public to take out private health insurance so that it can subsidise the public health system, which is not sustainable.

As Deputy Donnelly stated, it is not so much a question of how much we are spending on the health services, but how we are spending that money and where it is going. Ireland is one of the largest spenders on healthcare within the OECD. However, I am of the view that we are also one of the largest spenders on bureaucracy in our health service. Representatives from the HSE appeared before the committee last week. The HSE has developed a unit for scheduled care and unscheduled care and how it manages appointment waiting lists. How can we reconcile the amount of money we are spending on managing the waiting lists when really we should be putting that money into front-line services? The health service is a closed system. If investment is reduced in one part of the system, the patients do not go away; they just go to the next part of the system. That certainly is the case in primary care where if that is not properly resourced, people end up in casualty or on hospital waiting lists. I would like to hear a comment on that.

We often speak in abstract terms about how these things happen. I was recently contacted by a GP who had a patient who had pyelonephritis and a stone in her kidney. He decided to send that patient to the medical assessment unit where she could have her X-ray and ultrasound, and avoid going to casualty. However, the medical assessment unit said that was a surgical problem. The surgical assessment unit said it does not deal with renal problems and directed the patient to casualty. Here was a GP trying to avoid sending to casualty somebody who needs a diagnostic test. However, the patient ended up in accident and emergency and was obliged to start from the bottom of the assessment system again.

This happens every day. GPs are being sidelined and disenfranchised. They want to participate in the health system and look after patients and deal with chronic care. However, they are not given the resources or access to diagnostics. That is a practical example of how the system is not working.

Sláintecare provided a ten-year vision, but unfortunately we have a crisis intervention vision at the moment. We are not looking at the ten-year vision for the health service. As one of the witnesses mentioned, we are not capable of providing prevention measures in order to try to keep people out of hospital and avoid diabetes. We need to try to reorientate the taxes we take we collect from health taxes into the system. The Sláintecare report also recommended that those taxes be ring-fenced.

Earlier, Deputy Murphy O'Mahony asked if the Department of Health is negotiating on a new GP contract in good faith. Are negotiations on a new GP contract taking place or are we just adding bits and pieces to the old contract?

The contract negotiations have been going on for two years now but nothing has come from them. GPs feel they have been sidelined. They are anxious to participate in the health service and they are champing at the bit to get involved in looking after patients properly within the community. However, they are not being valued, recognised or resourced. I ask Mr. Varley to respond to my first question.