Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I welcome our witnesses to this important meeting. The issues they have raised have been discussed in the committee since the beginning of the year. We all acknowledge the tremendous work done by the health services over the past two years. Challenges came day after day and the medical personnel stood up to the challenges. We need that recorded because otherwise the challenges ahead cannot be faced.

I thank the witnesses for their opening statements. All of the issues they raised have been addressed by the committee since the beginning of this year because it is recognised that we can no longer have a haphazard approach to health services. We have an increased population and increased demand at every level and we need to do something about it.

My colleagues will speak for themselves but all members agree that it is not sufficient to go back to the people again and again to say we are very sorry but we cannot help them because the system does not work and we are in competition with everybody else in the world for personnel, staff or whatever the case may be. That does not wash any more. We have to do something about it.

What do we do? We enlist healthcare as the leading issue. We request that particular reference be made to the fact that Sláintecare has to proceed as was indicated. We noted that people resigned from the Sláintecare co-ordination committee and were assured that everything in the garden was rosy. We presume that is the case but we do not know. However, we know for certain that we do not have a separate budget. We cannot do the things the witnesses want to do. We do not have a budget to do so.

We are not the Health Service Executive. The HSE can do that and has to do so. The HSE now tells us that more money than ever before is available. It tells us again and again that money is not an issue. It is all there. Everything we ever wanted is there. It is now a matter of deciding that we address the issues. Hospital waiting lists are one issue of many. I get frustrated when we repeatedly say to the public we are very sorry that the situation is the same as it was last year or has got worse. What do we do?

Other countries are having problems with competition for staff. The reason for that in the nursing area is that nursing is heavy, hard work. It has been especially tough going over the past two years. In order to ensure we retain staff, we have to pay them. If that is the cause of the problem, money is available. What is the cause of the problem in the future?

Sláintecare must proceed. Any interim measure must be within the template of Sláintecare. We have said that again and again at this committee. We accept that progress must be within the template of Sláintecare in order that actions are not taken that cut across Sláintecare and render it useless. We mean to create a service that is acceptable, robust, available and accessible.

I will depart from my usual approach of addressing specific witnesses and instead speak to all of them. Do they know of anybody out there who is deliberately frustrating the onward progress the Minister and the HSE say is possible? Is it the HSE? Who is it? We cannot continue to make excuses. It is not acceptable to us as public representatives or to the general public. There is a notion nowadays that everything takes four or five years. That is utter rubbish. The Chairman and all of us around this table know that.

That is not true. It is possible to take measures that take effect in the next couple of months, so that is what we need. It is as simple as that. If it does not happen, we will be back to where we were. We have a plan for the future and great ideas but we are going to do nothing. That is what it means. Urgent progress is required. In any queue, the waiting list is whatever length it is - I am not going to go into the one million people waiting at the moment - and you have to start doing something about it. That queue has to be shortened, so you have to start at the two ends of it - the outer end and the immediate problem - and they must converge quickly. Whatever steps are needed to do that must be put in place now. That will be in line with the template set down in Sláintecare and that must happen. It is no good us saying we do not have Sláintecare ready yet so we will wait two or three years until it is up and running and do it then. That is not acceptable either so we must start at the beginning and end of the queue and converge. If that does not happen, we are facing a disaster because there are many challenges ahead.

I have been involved in the health service in one shape or form for a long time, as have all other members here, and we were told for years we did not need any more hospital beds. We were told repeatedly there was no need for hospital beds, there were already too many beds, we should get rid of them and it would be much more efficient to do without them. Well, now they know and everybody knows we need hospital beds.

We need to provide a service to the people when they want it. It is no good telling somebody to come back in four or five years, depending on the illness or immediate concern. We need to reassure the public. It is one of those things that needs to done as a matter of urgency. We need to reassure the public we are conscious of the position and have every intention of doing something about it in the current year, not next year or five years' time. We cannot tell members of the public to come back in five years' time and we will look after them then. That is outrageous; it is crazy. I have never seen it work in any other organisation and I have been looking at organisations for a long time. I will not specify what needs to be done. The witnesses all know what needs to be done. The money is in place. The HSE knows the money must be released strategically to provide the services that are needed.

There are people who say we cannot do that. This does not arise. There are no situations where something cannot be done. I remember how I was told by institutions five or ten years ago that something would take five or ten years. Where have we got to? I was looking at a case recently where a nurse who qualified outside this jurisdiction wanted to become involved in this country as a matter of urgency. Dealing with this kind of thing has been handed over to a private organisation. It was done six months ago and that was the last time they ever heard of it. We cannot go on like that. It is inefficient, ineffective and is not working. All the comments about the system being broken are correct. It is broken and is not working. However, it was able to work for the past two years in possibly a miraculous fashion. The health service in this country delivered in a way that was not expected of it. It was not expected of it because the health service has been dumbed down. Everybody criticises the health service. People working in the health service know it and do not expect anything else. We as politicians know that if someone is always being criticised and nothing is expected of him or her, you will get nothing from that person and nothing will happen.

The time has come to deal in a meaningful way with the issues that are emerging, and by that I do not mean in six months' time; I mean now. We need to get the response soon from the HSE and all the organisations we dealt with in January. We do not have a budget, we cannot enforce it, but we can highlight it, which is what we have done, and this committee was ahead of everybody else. Everybody was anxious going into the new year. With some subsidence in the virus, and while it has not gone away and is still around, we need to act now. That is all I want to say. I did not direct anything at individuals. I am merely saying that all those involved need to act now.