Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the witnesses. I thank them for their presentations, and thank them and all of their members for all of the work they do to keep the health service afloat, not only over the past two years where their contributions were outstanding but on an ongoing basis before and since.

It is remarkable that so many people have referred to the fact that there is a solution. We talk about these problems a lot, and have talked about them for donkey's years, but there is a solution which many have identified, namely Sláintecare. The issue is the slow implementation of that and the lack of buy-in from some people involved who are central to the health service. I do not think the committee needs to be convinced of that. Many of us were involved in drawing up that strategy.

What kind of engagement are the unions having, as key organisations within the health service, with the Government and, in particular, the Minister regarding the implementation of Sláintecare? Have there been meetings about that in recent times? I would be interested in hearing in their response what engagement, if any, they have had. That is the critical thing.

The slogan of Sláintecare is "Right Care Right Place Right Time", and that sums up in six words very well what we need to do in the health service. We have spoken about providing care at the earliest possible stage and at the lowest level of complexity. We know that within the health service the vast bulk of activity relates to chronic illness. About 70% to 80% of chronic illness can be perfectly managed, and is best managed, within the community.

Ms Ní Sheaghdha spoke about the commitment we are supposed to have to chronic illness management.

We have been talking about that for 20 years and it is the key to unlocking many of the logjams within the health service. There was mention of the need for clinical nurse specialists and advanced nurse practitioners but why are we not doing this? It seems to be blindingly obvious that this is where the emphasis should be within the health service. Why is the Government not rolling out the chronic illness programme and why do we not have those key senior nurse posts in place to the extent required?