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

I welcome the Minister and congratulate all those involved in making the strides that have been made over the past three years through the lockdowns and the pandemic. Trojan work was done by all sectors of the health service despite the magnitude of obstacles thrown in their path, but this work must continue apace. Issues remain that are not within the capacity of the staff to deal with and they will need the guidance of management throughout the process. They include the shortage of spaces in various hospitals, in the south west in particular, such as in Limerick, as well as issues relating to capital versus current costs. A debate takes place every year in every Department in advance of every budget regarding capital versus current expenditure, the theory being the capital can be delayed in favour of current. There are reasons for that, of course, as we well know, but it is not a good idea to postpone capital investment for any prolonged period. In that regard, could emphasis be placed on the delivery of capital projects in the near future? I do not want to start naming places in my constituency or anyone else's, but Naas hospital comes to mind. I raised it on a couple of occasions recently but I did not get any feedback, which always makes me suspicious, and suspicion regarding a Department is a dangerous condition for a politician to have.

I welcome the additional expenditure in the health services and the additional staff being provided. The next question the general public will have relates to what the benefit will be. What will be the visible impact for patients or the family members of a patient? How will they see it in the future development of the health services and the incorporation of Sláintecare? The public want to see progress, and they measure progress through their level of access to the services when they need them, and particularly the public health service. It is essential now to emphasise the various ways and means that can be used to move forward the project at all levels, bearing in mind a crisis is looming in respect of GPs throughout the country but especially in areas with a rapidly growing population. It has been brought to our attention that this applies in particular where large numbers of refugees, for good reason, have to be located. Some people see this as a negative issue but I see it as a positive one. It is positive in the sense there may be a need to augment the back-up health services, such as GPs, access to community care and so on, and now is the time to do it. When the necessity arises, we should by all means do that to meet the needs of both the current and incoming population.

Another issue concerns extending schemes for women and various GP care schemes for those on or below the median household income, retaining the drugs payment scheme threshold and so on. All that is welcome and will be welcomed by the people at whom it is directed. In particular, women's health, and men's case as the case may be, will come into sharper focus in the years to come, having regard to the experience of various schemes that did not go the way we wanted them to go. Tests were taking place both outside and inside the country and in the case of some mistakes that were made, it would have been better if they had not been made, if I can put it that way. I am talking about CervicalCheck and so on. We need to keep an eye on all cancer tests. Whether they relate to health services for men or women, we need to keep a close eye on them.

Funding provided for building capacity is important. There is no use crying about the lack of hospital beds if there is nowhere to put them or no additional buildings in which to locate them. The same is true of all the other services. There has been much criticism of the children's hospital regarding the number of beds and rooms. I had occasion to visit one or two of these institutions in recent times. There is an absolute need for all the accommodation provided in these hospitals, including consulting rooms and additional beds. There is a revolving door because the patient is moved from one place to another as necessary and it is not appropriate to cart patients, say, a quarter of a mile within a hospital when accommodation can be made readily available. The national children's hospital is a fine project. It has been going well and services continue to be provided on the rest of that site while the building has been taking shape, although, obviously, they have been restricted. One impedes the other, to a certain extent, but it has been going well. I am not a critic of the end cost. I have never believed there are grounds of criticism, as the Minister will recall from his attendance at these committee meetings. We need to continue apace to bring the process to a satisfactory conclusion as soon as possible and to allow the development of the rest of the health services, such as the new national maternity hospital, to continue as well. The lesson to be learned from all this is that we cannot take the steps we need to take without spending and providing the money that needs to be spent. There will always be those who say something is too expensive or that we cannot afford it. That is fine; let us just accept second-grade services. In any sphere of life, whether broadband, the health services or anything else, we cannot achieve our targets without spending and investing in the infrastructure.