Mary Harney (Dublin Mid West, Progressive Democrats)

We cannot continue to put more and more money into the health services without serious reform, a fact everyone in the House acknowledges. The good news is that we have more nurses per capita than any other country in the OECD, although they and other health workers do not come cheap. In order to meet benchmarking and salary increases next year, we will need an additional €500 million.

One of the priority areas is accident and emergency units. It is unacceptable that people have to spend upwards of 12 hours on a trolley before they are admitted to a bed in an acute hospital. Allied to that are step-down facilities for the elderly, many of whom are in acute hospitals because there are no alternative services. A second ambition of mine is to reduce waiting lists. In that context, the national treatment purchase fund is making a major impact having treated 19,000 people to date. I want to continue to fund and support that, perhaps by extending its remit, because it is having a major impact through the use of facilities in the independent sector in Ireland and elsewhere to treat patients who have been waiting a long time.

A third priority area is the extension of the income thresholds for medical cards, which we all accept are too low. I cannot give commitments in regard to numbers but it is important that we concentrate on income thresholds, which I will make a priority. I also intend to prioritise oncology services.

I hope that in two and a half years we can make major achievements in those four areas as well as in health promotion. Ireland's health spending since 1997 has been double the OECD and EU averages. When spending is combined with outcomes such as dependency on alcohol, as Deputy Kenny acknowledged, suicide, cardiac disease and so on, the ESRI's combination of findings puts us in the position reported today. It is the Government's top priority in the next two and half years to accompany additional resources with radical reform.

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