Enda Kenny (Mayo, Fine Gael) | Oireachtas source

I understand the difficulty the Ceann Comhairle has here. Deputy Martin raised three issues, namely, health, mortgages and jobs. The role of the Cabinet committee on health is to provide for political oversight on the development and delivery of the major health service reforms in line with the commitments in the programme for Government. It has met twice so far in 2013, on 14 January and 11 February. The next meeting is scheduled for this month. Deputy Martin is aware of the programme for Government, which sets out the reform and change agenda aimed at improving the model of Irish health care and delivering better services in the community and is also focused on preventative measures. It commits to developing a universal single tier health service which guarantees access for everybody to health care based on need as distinct to income. The document, Future Health A Strategic Framework for Reform of the Health Service 2012-2015, published last November, sets out the main health care reforms to be introduced in the coming years as the major building blocks for the introduction of universal health insurance in 2016. I welcome the strategy in place which sets out 48 specific actions which give a clear sense of the work which lies ahead and the timelines to accomplish this. The Cabinet committee on health will continue to monitor the delivery of these major key reforms.

We have seen a number of developments recently. These included the publication of the preliminary paper on universal health insurance setting out progress towards developing a White Paper on universal health insurance as was committed to; the development of policy proposals for the concept of money following the patient, implementation of which is to commence later this year following a period of consultation with those involved; a new implementation framework for disability services, moving to a new model of individualised services whereby the allocation is given to the person involved who might be in a far better position to know what might be more appropriate for his or her particular needs than it being provided centrally; and work on the hospital groups, which Deputies are aware is at an advanced stage as the first step to moving towards the establishment of hospital trusts, which is a key requirement for universal health insurance. I expect the Minister to be in a position to finalise the hospital groupings, and the documents in respect of the future of local hospitals, in the coming weeks.

More generally, the Government has made good progress with regard to health service provision and more general changes, and some developments are worth noting. On 20 February the EU Commission approved the new permanent risk equalisation scheme in the Irish private health insurance market. The national early warning score for Ireland was launched. We now have the first national clinical guides to recognise and respond to patients in acute hospitals whose condition is deteriorating. We have had the launch of healthy Ireland, a facility to support a whole of government and whole of society approach to disease prevention and health and well-being promotion. As I have often stated, we understand from health professionals that we face having 250,000 diabetics in the country in the coming years. Most of these cases are preventable through activity, exercise and diet information.

Continued progress has been made in achieving improvements in hospital access targets and reduced waiting times. The new deal with the pharmaceutical companies will reduce the medicines bill by €400 million over the next three years. Approximately 250 new mental health posts have been filled, with further recruitment progressing. We have also increased the budget for the National Office for Suicide Prevention to more than €8.1 million. Progress is being made in 2013 with regard to extending free GP care to people with long-term illness. An additional €35 million has been allocated for further development of mental health services, including the recruitment of more than 470 additional staff. A review of the fair deal scheme will be completed in 2013. We have new governance arrangements to progress the national children's hospital. We also have a new legal framework for the imposition of charges on all private inpatients in public hospitals. These are some of the issues which have been raised during the course of the deliberations of the health committee.

With regard to mortgage arrears, the Cabinet committee was established last year and its role includes overseeing the effective implementation on a cross-departmental basis of the Government's response to the issue, agreeing a detailed implementation plan for the recommendations of the interdepartmental report on mortgage arrears and ensuring proper priority of this implementation by Departments and agencies.

Its role is also to develop any further measures in regard to mortgage arrears required in light of the developments and to oversee and ensure facilities for sufficient finance for small and medium enterprises, which has been a real difficulty for so many small firms. That matter has been raised by Deputies of all parties. Its role also includes monitoring, in conjunction with the Central Bank, the performance of lending institutions against agreed indicators and targets in those areas.

The director of the insolvency agency will announce details of the conditions that set out opportunities for people who may enter into the personal insolvency arena, as well as how they are recommended costs in respect of having a decent standard of living and working out a solution for their particular problem. I understand that announcement will be made on Thursday afternoon.

We welcome the publication by the Central Bank and have had presentations by its Governor concerning specific time-bound targets for the six main banks to ensure early and measurable progress towards its objective. This was also referred to at the meeting yesterday. Those targets will become progressively more demanding as time goes on, so that a solution will have been proposed for the vast majority of distressed borrowers by the end of 2014. A 20% offer was to be made to persons by banks by the end of July but that probably will not appear until the quarterly reports come in.

In the coming months, the Central Bank will also set quarterly targets for the conclusion of sustainable decisions and solutions, and for the subsequent performance of those solutions. There is an issue of psychological relief for people who will find that an agreement has been reached in their particular circumstances which, as Deputies will know, are all different.

As regards whether there will be write-downs as a result of the targets, the Government's approach has been clear on this matter. Mortgage holders who can meet their own obligations should continue to do so - the vast majority do - so that appropriate assistance should only be afforded to those mortgage holders or other borrowers who are experiencing real or genuine difficulties in meeting their commitments. That approach is recommended by the Keane report.

Clearly, the Central Bank has obligations in respect of its licensing arrangements and will continue to examine the appropriateness of capital requirements in the context of mortgage arrears in the case of the specified credit institutions. The Central Bank will have to consider the imposition of capital add-ons where any of a range of things apply, such as if credit institutions have poor mortgage arrears resolution strategies, where they are not well executed or where the public targets set have not been met.

The most recent capital injection of the covered banks took place in 2011 and arose from the Central Bank's prudential capital assessment review in March 2011. That PCAR assessment was based on macroeconomic and loan loss assumptions on all parts of the loan book, including mortgages of the covered banks. The Central Bank has clearly stated that banks now have a substantial buffer with which to absorb losses on their mortgage portfolios.

That issue, concerning a reasonable standard of living and reasonable living expenses, will be outlined by the director of the insolvency agency on Thursday afternoon. If a person decides to enter into that process, the issues of a reasonable standard of living and reasonable living expenses - contrary to a perception that is out there - are not binding on the persons involved. Therefore, issues that were raised in recent weeks do not apply.

I have already referred to the question of jobs during Leaders' Questions. The problem we face as a country is that we have rebuilt our international reputation which has been accepted because of the performance economy here. I have met with company representatives who are exceptionally well pleased with the quality of the talent pool available to their sectors, be they pharmaceutical, IT, ICT or others. Exports have been strong despite the poor conditions of some other European countries. The corporate tax rate is clear and that export performance has been in double digit figures. From that perspective, the international element of the economy has been performing well. The problem and challenge for us is to get our indigenous economy performing well, which means having opportunities to create jobs and get things moving. That is why the Government has taken a number of decisions on access to credit for small and medium enterprises. The problem has been focused on by the Government whereby there are specific targets for banks to provide new lending this year, as distinct from restructured loans. In addition, the microfinance agency is involved along with other elements of the partial loan credit guarantee system. The €2.5 billion stimulus package that was announced by the Minister for Public Expenditure and Reform, Deputy Howlin, is tied up with the public private partnerships. As Deputies will be aware, this process is both complex and time consuming. I will provide the House with an update when I have the details of the projects, ranging from Grangegorman to the schools and roads developments. That is where the challenge lies.

Deputy Martin mentioned NewERA and the National Pensions Reserve Fund.

See this speech in context