Enda Kenny (Mayo, Fine Gael)

Over €13 billion has been allocated for the health budget for this year, which will be a very challenging year. Clearly, this will require serious analysis of the structural changes that have to be made. What do we in this House want in respect of our health service? We want a service that is provided for people as close to them as possible, that deals with their medical needs as quickly and efficiently as possible and to the highest standard possible, based on the most efficient cost, as distinct from what they have in their pocket.

We can pretend things are going to be as they were, when person after person has pointed out for years the inefficiencies that have been contained within the health structure. The Minister, Deputy Reilly, is not afraid to tackle this problem. We must get to a point where the Government's objective of having universal health insurance made available for every person, treated on the same basis, at the end of the Government's term, is brought into being. This means focusing now on the provision of primary care centres, whereby people do not have to go to accident and emergency in the first place and there is a clear emphasis on community care.

Why is it that up to 40% of people who are assessed for long-term geriatric care are never asked where they would like to be? The vast majority of people I come across, and who we know of from all over the country, want to stay in their own homes for as long as possible. We do not want a situation where people are being sent from acute care hospitals directly into long-stay institutions. We can either continue with what we had or we can change it. We are going to change it. We want a situation where people go from acute hospitals into step-down centres until they are better and can go back to their own homes, backed up by proper home care packages and community care-----

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