James Reilly (Dublin North, Fine Gael)
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Deputy Ó Caoláin quite rightly pointed to the reduction in our budget and staff numbers over the past several years. He contends this has done significant damage to the health service. He does not acknowledge that it has actually improved because reforms have been carried out.

A deal was done with the Irish Pharmaceutical Healthcare Association, IPHA, which will yield savings of €400 million over three years, greatly in excess of what was originally on the table. The Deputy referred to failures to save money on drugs and failures to obtain moneys owed by private insurers. We now have accelerated payments of €125 million from insurers last year, which more than accommodates the savings that were supposed to be achieved from the private patient charge and the reduced drugs savings.

Health is a demand-led service. That demand is created because people are growing older, many more people have medical cards because our economy is in such a state, and many more babies survive problematic births but require high-tech support in their early years. Our aging population means we will have more demand for chronic illness services in the future. By 2041, it is projected there will be an estimated 1.3 million to 1.4 million people over the age of 65 years. The greatest increase within that cohort will be among those over 80 years of age.

I reject the contention that we are travelling in the wrong direction in health policy. First, we will introduce free general practitioner care. Rather than spending much time overcoming legal issues concerning the cost of high-tech drugs for long-term illnesses, we have decided to approach that area in a different way. A paper will be going to the Government shortly. It will not only show our bona fides but give people something real. Up to 43% of the population, the highest number in the history of the State, is covered by medical cards, a fact contrary to the what the Deputy suggested. Another 1% is covered by the free GP card, meaning 44% of the population is covered. This shows that the figures are going in the right direction.

The home help budget in 2013 was restored to 2011 levels. The Deputy referred to a 8.6% reduction in primary care funding. That is not a reduction in home help funding. That is across primary care, where there are savings, to which Deputy Ó Caoláin alluded, on drugs, prescribing and fees paid to professionals.

I am not just telling the Deputy improvements have been made in the health service. I can show him these improvements. We had a 24% reduction in the number of people who had to endure long trolley waits last year. We have had a further 9.1% reduction this year, despite the prolonged winter. We have reached a target of 95% of endoscopies being carried out within 13 weeks, as well as the treatment of children for inpatient procedures within 20 weeks and the treatment of adults for same within nine months.

Deputy Healy contended that there has been a cut in the nursing home support scheme. Ms McGuinness will address that more comprehensively later. However, from the figures it can be seen that more than 22,000 people are being catered for. We need to reform that as well in terms of looking at more tiered supports for people who wish to stay at home, as most people do.

As for the number on trolleys, it was 569 in January 2011, averaging 400-plus per day. We brought that down to the point at which yesterday’s figure was 239, with 79 waiting longer than nine hours. On the same day last year the equivalent figures were 258 and 112. This day last year, there were 284 people on trolleys; today there are 204. I acknowledge that there are too many people who have to endure long trolley waits, but to try and say the numbers are going up is not just disingenuous but disrespectful to the people who have done so much hard work on the front line to make this possible. I thank them for the great work they do every day on behalf of our citizens.

The clinical programme for the frail elderly meets the needs of such patients when they are admitted to hospital, and they start rehab straight way to ensure they do not end up staying in hospital in the delayed discharge category. The stroke programme has meant that in 18 months we have gone from the bottom of the list in Europe to the top in terms of the number receiving thrombolytic drugs and therapy. That saves one life a day. The congestive heart failure programme is making life much better for our patients too. As for waiting lists for outpatient services, Deputy Healy does not acknowledge that this has been the first Government to quantify the problem and address it in a real and methodical fashion.

A memorandum will be going to the Government in the next week on the national children’s hospital. Our plan is to have a brownfield site on 1 January 2015 with full planning permission.