Liam Twomey (Wexford, Fine Gael) | Oireachtas source

I have huge sympathy and regard for carers and the vulnerable people who depend on their support. Like many Members, we are not happy with the cuts to home help and care packages for the most vulnerable. The health service, however, is difficult to manage properly. There is no shortage of critical issues in health. These critical issues are constantly competing to become the most urgent issue for the Government of the day. If we look through the health service,s we are starting to see huge structural defects across the administration and set-up of the health services. We are trying to address those issues against a background of massive budgetary adjustments at the same time. Tonight we are talking about carers and home care packages, but there are other significant issues in health at this time that are just as urgent and considered just as critical by the people involved.

There has been a major shift in the mental health services from inpatient care to community care, and the Minister of State, Deputy Kathleen Lynch, is dealing with it carefully and sympathetically because it requires a new mindset on how to manage patients with serious mental illness. That should be acknowledged, as should the Minister of State's work.

We must also reduce waiting times for patients. For the first time in my career, and I have been involved in health for 25 years, I know how long my patients must wait for an outpatient appointment. This was information we did not have before and we must reduce those times as quickly as possible, but it requires a massive change in how the hospitals are managed and how doctors, nurses and physiotherapists do their jobs. There is no idea what we must overcome to get that right in order that we can see patients quickly.

We are now working on reducing the costs of drugs because they were out of kilter with what we should have been paying, and the Minister of State, Deputy Alex White, has been given the responsibility of getting primary care to work better. This is an area with which I was involved before I joined politics, and I am still involved with it now. I have seen significant changes in general practice, even since I came in. Some of the drugs we were using to treat patients when I first qualified as a GP are considered obsolete. The treatments for patients are completely different from those I was trained to administer as a junior doctor. There has been an explosion in the use of IT within primary care. The ways we manage out of hours, the paramedics and ambulances have all changed. We are constantly working with the HSE and the medical colleges to make those changes happen.

I am enthusiastic about how change will work in primary care and how doctors, physiotherapists, social workers and home care teams will all work together for patients. We are so good at being cynical and hypocritical in this Chamber about this topic that we need to be more positive and say what is working well. There are problems, but many of them are from the background of wasting money in the health service and many of these reforms were highlighted when we were in opposition. We highlighted the changes that must come about and they are now coming about because we have a Government that is focused on making change. If I was to make any criticism, it would be that we should do it even faster. These reforms will work and will deliver better health services.

I have listened to so many Members on the Opposition benches opposing change and I have watched over the years when people opposed the cancer strategy and major operations in small expert centres. In spite of what is happening in Roscommon, Deputy Flanagan might one day acknowledge that the changes might be good for the people of Roscommon. Perhaps, however, he dug himself into a corner and cannot acknowledge it. I have seen the changes happen in recent years and I have seen things getting better for patients.

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