Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I welcome the Minister, and I wish Ms Magahy the best of luck. She has taken on a Herculean task. Fianna Fáil has signed up to Sláintecare. It helped to write it and would like to see it implemented.

Healthcare reform is difficult and complex and regularly fails in different jurisdictions around the world. One of the things it requires is credibility of leadership, and I am worried by parts of the statement the Minister has made. Understandably, he is looking to the future, but there is no reflection on the problems we have at the minute. Since 2011, healthcare spending has gone up every year, per person and when adjusted for inflation, and yet waiting times across the board for men, women and children all over Ireland are worse than ever.

For the third year in a row there has been a massive budgetary overrun and it is fair to say that clinicians all over the country are at their wits' end.

I will focus on waiting times because the issue affects patients the most. Children with special needs are waiting three and half years for treatment. Young children with scoliosis are waiting three years for treatment. In the rest of Europe spinal curvature is not allowed to exceed an angle of 45 degrees but in Ireland the limit is 100 degrees. For the first time ever, the number of people on waiting lists has exceeded 1 million. When one adds the National Treatment Purchase Fund, NTPF, figure to all the other figures, the number totals 1 million people, which has never happened before. In spite of annual increases in funding, the position is worsening. Let us take the number of people waiting for surgery for more than a year. In 2010, that figure was slightly more than 700 people but now stands at 14,000. For every one person in Ireland who was waiting over a year for surgery in 2010, there are now 20. This goes to the heart of credibility.

My real fear is that the responsibility for fixing these failures is now being put on Sláintecare. The presentation lists seven Sláintecare objectives. I will not read them all but I put it to the Minister that four of them should have nothing to do with Sláintecare as they are the job of government. Promoting the health of our population is normal healthcare. Moving our system from long waiting times to a timely service has nothing to do with Sláintecare and is the job of the Government. Waiting times were falling drastically and were 20 times lower in 2010 than they are now in certain areas. Accountability and performance is also the normal job of healthcare management. I am concerned that there is a lack of acknowledgement of just how bad things have become in healthcare for patients and clinicians. Sláintecare is being given the role of system reconfiguration and moving to a more modern model of care. That is its responsibility but I am concerned that Sláintecare is being tasked with fixing the problems that are the normal job of Government to fix, for example, waiting times and avoiding significant budgetary overruns every year.

In the spirit of trying to get this right, does the Minister accept the failures in the healthcare system today, particularly in terms of waiting lists which are longer than they have been since records began? Does he agree that in order to implement a very serious and ambitious programme of change, we will need much more competence in delivery by Government based on what patients are facing every day? How does he plan to provide that competence given that what we are facing and what we have all signed up to is a complex, difficult and important programme of change?