Oireachtas Joint and Select Committees

Wednesday, 6 February 2019

Joint Oireachtas Committee on Health

Quarterly Update on Health Issues: Discussion
Quarterly Update on Health Issues: Discussion

9:00 am

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I take as noted Deputy Brassil's comments on the nurses' dispute. We will have an opportunity to debate that in the morning but I hope that between now and then, there will be a continued effort to get this back into some formal engagement because that is the only place where it will be resolved. The floor of the Dáil is a perfectly appropriate place to discuss it but it is not going to be resolved there. It needs to be back in our industrial relations mechanisms. That is where we need to get to.

I would be happy to provide Deputy Brassil and the committee with a note about the GPs. The most up-to-date and accurate position is the one issued by the IMO to its members this week, a copy of which I can also send to Deputy Brassil. Significant progress has been made between the IMO, my Department and the HSE to try to move to a point where we move beyond FEMPI. Obviously, there are things we need in return from GPs for significant additional investment. We have a lot of money that we want to spend in general practice. We have been talking about this for a very long time. The fact that the IMO is reporting progress this week to its own members is significant in itself. I know the IMO and I want to bottom it out this month. I will send Deputy Brassil and perhaps the committee a note about where we are at. I will try to do that today.

Regarding the implementation of Sláintecare, we are at the point where I am about to publish the action plan for 2019. I will give the committee a slight preview of what are likely to be the priority areas this year. Geo-alignment is one area. One of the key recommendations of Sláintecare was that we cannot continue to have the siloed structures so we cannot have hospital groups and CHOs, separate budgets and separate management structures. Deputy Brassil understands this. How do we get there? What does the map of Ireland look like effectively? Geo-alignment will be significant this year. Elective-only hospitals constitute another issue. What do they do, what range of services do they provide, and ultimately, where do they go? The third key element I would highlight is the integration fund. We have a ring-fenced integration fund this year. There are a couple of really good pilot projects such as the Sligo primary eye review and the musculoskeletal physiotherapy service. Could we use that integration fund to roll out what we know are successful projects locally to a broader region or indeed to the country this year? The action plan will be published in the next few weeks.

Regarding the children's hospital and the quantities, I am giving a general answer to the specific question asked by Deputy Brassil but I did make the point earlier about not pre-empting the PwC report. What is apparent in advance of it is that the prices per unit had been locked in at 2016 levels. What was clearly completely off the Richter scale were the quantities that would be provided. While there are a number of elements involved in how we got from €983 million to €1.4 billion, a very sizeable element was the fact that when the National Paediatric Hospital Development Board went beyond outline design stage to the detailed design, somebody got the quantities seriously wrong. That is one of the things for which we are paying a significant price today. I expect PwC to be able to get to the bottom of that. Professional companies and people with expertise were used. Through its agencies, the State would have had contracts with these people in terms of the provision of services and we must consider what action can be taken in light of the PwC report.