Seán Kyne (Galway West, Fine Gael) | Oireachtas source

Of all Government responsibilities, health is perhaps the most significant. The provision of health services is a vital aspect of any functioning and compassionate society and one of Government's most important tasks. Everyone requires health care at some point in his or her life. Ensuring that all who need care receive it depends on careful planning, the allocation of significant resources and astute management. It is often overlooked that tens of thousands of citizens are successfully treated each day in our clinics and hospitals. People also overlook the fact that this year the Government will spend €13.5 billion on the health service which figure represents just under 27% of all Government spending. That one in four euro the Government spends will be spent on health is a clear measure of the importance Government and citizens attach to health care.

Providing health care is but one of the obligations placed on the Government. It also has a duty to ensure that the funds raised from taxpayers are spent as efficiently and effectively as possible. This is where the Health Service Executive (Governance) Bill comes in. Given the current financial situation, the goal of the Government is to cut costs but not the level and quality of care. This entails doing more with the significant investment which has already been made while ensuring that every extra euro spent goes further in tending to the health care needs of the people.

The efforts of the Minister and Ministers of State at the Department of Health and of the thousands of doctors, consultants, nurses and other staff are evident though not often reported. These efforts have led to exceptional improvements including a year-on-year reduction of 24% in the number of people on trollies in our accident and emergency departments. There has also been a substantial reduction in the number of adults waiting nine months and more for in-patient and day-care surgery from 3,700 in December 2011 to just 86 at the end of December 2012. There has been a 95% reduction in the number of children waiting more than 20 weeks for in-patient and day-care surgery and a huge reduction in the number of people waiting 13 weeks or more for routine endoscopy procedures from 4,590 in December 2011 to just 36 at the end of 2012. These vital improvements are the result of better use of the funding allocated to the health service. Improved management structures have gone hand in hand with the improved use of funding.

The announcement of the establishment of the HSE in 2004 seemed to herald a radical and bold departure from the health board system. Gone, we were told, would be the narrow, local focus while efficiencies and increased effectiveness would result from a new, businesslike approach.

Unfortunately, we know what happened. These much trumpeted plans never materialised properly. Instead we saw name changes, new titles and extra management layers, with little or no progress. The most valuable asset of all - the human resources - was not addressed in any meaningful strategic sense and merely transferred from one employer to another. Ultimately, the Government has inherited a brand in the HSE that has been damaged and does not inspire confidence among the people it is supposed to serve. For that reason, the Government has embarked on an ambitious programme of reform which will take time to implement but which will represent real change with visible results.

The Bill is part of that reform process. It contains an interim suite of measures that will provide the powers needed for decisive action and enable the Minister to more ably lead the way in reforming the health service. The new approach espoused by the Bill can already been seen in the much needed improvements in the work in the west with the new Galway-Roscommon hospital group under its CEO Mr. Bill Maher. The group has seen significant improvements and results in the past year. The number of patients seen and treated was above the target set out in the service plan within the confines of a reduced budget and staff. Galway University Hospitals met one of the key targets of the Department of Health's special delivery unit in respect of inpatient waiting lists in 2012 - that no adult should wait longer than nine months, that no child should wait longer than 20 weeks and that patients requiring scopes should be seen within 13 weeks. Progress was also made in 2012 on the length of time patients had to wait for admission from the accident and emergency department. In February 2012 there was an average figure of 24 patients awaiting admission at 8 a.m. in Galway University Hospitals. This number was reduced to 12 in November. From talking to staff in the hospitals, one can see there is a newfound confidence that the Galway-Roscommon hospital group is working well with a reforming and efficient new CEO. It is great to see such progress. This is the model we want to see rolled out across the country with these results.

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