Professor Steve Thomas:

I do not share all the Senator's concerns about inefficiency, but I hear them. In the Sláintecare report there is quite a large focus on changing the current inefficient system to one that is much more efficient. My worry is that if we allow the system to just persist as is then the inefficiencies will also persist. If one looks at what Sláintecare is trying to do, it is moving care from where it is currently provided into lower care settings, which is moving it out of acute care settings into community and primary care settings where it is being done much more efficiently, quickly and responsively. It is changing the skill mix around the delivery of some care where we are not so reliant on doctors to provide care. We are looking more at alternative provision of different kinds of care. The free GP and practice nurse access for children aged under six is an interesting case in point. We need to think creatively about how we provide that care so the system is not unnecessarily burdened, and see if we can we use more practice nurses in that kind of setting. We need to look at how we do that and think about it creatively.

Sláintecare is about doing things in a low-cost public care setting rather than in a high-cost private care setting. We presented interesting data last week from EUROSTAT around European healthcare expenditure. It shows that Ireland is the third most expensive country for voluntary health insurance spending per person. Ireland is actually the 12th most expensive in terms of Government funding per inhabitant. We must be careful not to believe the myths some people put out that we are spending far too much money. It is more about how and where we spend it. Sláintecare is critical to changing the way that is done. It requires transition and that is quite a difficult process, and sometimes slightly expensive in the short run. What it then delivers, however, is a system that operates far more efficiently.