Simon Harris (Wicklow, Fine Gael)

I welcome this opportunity to speak on the issue of health and I very much welcome the attendance of the Minister for Health in the Chamber. When we talk about the issue of health, it is important to acknowledge, as my colleague Deputy Buttimer did, the work of the health professionals. All too often since the creation of the HSE, we have an image of the health service being run by men and women in suits who brief us at Oireachtas committees but day in, day out health professionals, be they nurses, doctors or health care assistants, work in our hospitals and health centres and despite the financial difficulties and the reduction in their numbers, they get on with the job. It is important to put on the record that surveys carried out reveal that patients' satisfaction with the level of care they receive once they access the service is very high.

It is clear following the years of the Celtic tiger that money alone will not fix the health service. We have seen that. We have seen money being thrown at it, health budgets being hyped up every time there was an election and money thrown around with scant regard for what it would deliver. What will fix the Irish health service is reform and management. That is what the Minister, Deputy Reilly is about, and it is what Fine Gael and our colleagues in the Labour Party said in the general election campaign. That is our commitment in the programme for Government.

The Minister, Deputy Reilly and the Fine Gael Party never said that reform would be easy. It is much easier just to throw money at problems. Crucially the Minster and the Fine Gael Party never said it would happen overnight. The Minster went further than that, he produced a timeline showing that the full reforms this party in government wants to introduce will take more than the lifetime of any one specific Government. Already after a period of 15 or 16 months progress can be seen. The figures do not lie. With the establishment of the special delivery unit, as alluded to my colleague Deputy Heydon, we have seen a significant reduction in waiting lists: the 12 month list has been reduced by 95%, the 9 month list has been reduced by 55% and there has been a 19% year on year improvement in trolley waits. These are trolley figures which show an improvement at a time when less money is being spent on the health service. Already the reforms and the new structures are working. We have seen an emphasis on the issue of primary care in the rollout of primary care centres and progress is being made in the rollout of free GP care.

The Government has to untangle a massive mess. The creation of the HSE was a disaster for the Irish health service. It is ironic that the founder of the HSE, who is now the leader of his party, put down a motion bemoaning the very monster he established and imposed on the Irish taxpayer.

I want to make a few points on issues I have noted in regard to the HSE when representatives of it have come before the Committee of Public Accounts. Part of the reason the HSE has such a deficit is due to the fact that it seems to operate in silos. No one seems to talk to anybody else. Every little section tries to make savings but there is no overall examination of the impact of these savings on the health service. For example, it seems the procurement unit is so desperate to make a saving that it does not analyse the impact of that saving on the rest of the health care service. This is out of sync with how modern health services work. To use a simplistic example, a procurement section could decide that instead of buying a bandage for €12, it would buy one for €2, thereby saving €10 but that bandage might need to be changed by a community nurse who would visit a person in his or her home every day or every second day rather than once a week and the impact of that is not taken into account. When we talk about savings in the health service, we need a much broader approach. We need people to examine the whole health care impact, the impact on the patient and the saving across the system.

It was astonishing that when the chief executive officer of the Health Service Executive was before the Committee of Public Accounts he could not tell me as a taxpayer, let alone as a parliamentarian, what increments are being paid out for people in the HSE earning €70,000, €80,000, €90,000 and more, this year. We discuss public service and public service increments and the public service versus the private service. It is entirely missing the point. There are some very well paid people in the health service at very senior managerial level and I want to know how much they are earning and how much their salaries are being increased by. The fact that the Accounting Officer could not give this information to an Oireachtas committee is quite astonishing.

It is also equally astonishing that he appeared at a committee a week after the report on the death of children in care, many of whom died in the care of the HSE and he was unable to give me an assurance that all HSE staff are now complying with all guidelines and that there are no longer shop stewards telling people not to fill out referral forms and pieces of paper.

Last night many speakers raised the issue of school-leavers with intellectual disabilities. This is a real example of the system not working. The HSE and the Department of Health are fighting, lobbying, squabbling with service providers. I believe that service providers can do more but I also believe that the families of people with intellectual disabilities do not really care about the argument; they want the solution.

The Government has had a very positive 15 or 16 months. This motion is ironic and cynical at best and I look forward to watching the continuance of the agenda for reform under the Minister, Deputy Reilly.

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