Finian McGrath (Dublin North Central, Independent) | Oireachtas source

I raised the issue of the need for a cystic fibrosis unit. I remember the shenanigans and blazing rows we used to have behind the scenes between the HSE and the Department of Health and all we wanted was to have the unit built. I remember the many long meetings and fighting in pushing the agenda. I learned a lesson that such a situation could not be allowed to carry on. I hope this legislation deals with such issues. It is welcome that the unit was eventually built and I commend all those involved, but by God, it was a case of sitting on a plan for four to five years before we got it up and running. Issues arose between the Department of Health and the HSE and I was in the middle trying to keep the project on target.

Free GP cards are due to come on-stream for young children and I welcome the broad thrust of the initiative. When one is involved in reform, one must try to bring others along. People must be involved in the negotiations and one should not start a row over nothing or contribute to something that is negative. It is also important to consider the pitfalls. If people have concerns, it is important to take a sensible approach. In this context, I hope the Minister will listen in the coming weeks to the views of GPs.

If they state they may have issues with queues in their GP services let us see what we can do about it rather than getting into the blame game syndrome. The IMO has expressed concerns recently. One issue it raised is that efforts by the Department of Health to rush through the fundamental changes to the GP GMS contract without negotiation will lead to a service which cannot deliver what has been promised to patients. The IMO has warned the change proposed would fundamentally alter the way GP services operate in Ireland and lead to long delays for GP appointments, a massive increase in administration, costs for GPs and ultimately a shortage of GPs. The Department of Health is refusing to negotiate these matters for the first time in the history of the GMS. I ask the Minister of State to bring the message back to the Government there should not be a row and these issues should be dealt with through negotiations at which a deal is hammered out. I know this well from my own past.

Every year an estimated 24 million clinical consultations are done by GPs in the country. General practice is the most accessible, effective and trusted part of the health service. It can do much more to help patients in the community and alleviate pressures and costs in other parts of the health service. The IMO states it is committed to a GP service free at the point of access to all patients in Ireland, but the proposals announced by the Government are not capable of delivering this. We should examine the issues. We need planning, resources and negotiations so all patients have a quality health service. I have outlined some ideas which have come onstream. The Opposition is often criticised for not putting forward new ideas. The Minister of State and the Government should examine these issues, get on with it and stop the fudge.

It is important that we state the Health Services Executive (Financial Matters) Bill is a huge opportunity. We have had problems in the past and we are now having a big clean out following the disastrous banking crisis. Now is a good time for reform. There is much in the legislation which is good and I welcome these aspects. It is not only about legislation; it is also about the quality and efficiency of staff and we must examine this in the health service, education and throughout the public service. If somebody is paid to do a particular job and does this job well it leads to efficiency and productivity. Where people opt out of doing their jobs well it begins to break down. It is not all about legislation, the Dáil, Deputies, the HSE or the Minister. If everybody went to work and did their best at their job many of these issues would not arise. In the health sector one must give 100% and it is not acceptable to fall below certain standards because we are speaking about people's lives, quality of life and public safety. It is important to emphasise this.

I welcome the broad debate on the legislation. I strongly support the reform agenda because we need reform in our health services. As part of the reform agenda patients should be put first. People with an intellectual or physical disability should be prioritised. The money must go to the right places. This was a criticism in the past and we have seen the recent scandals. We must ensure the money and limited resources in a time of economic crisis go to the most needy. I welcome the legislation and look forward to hearing the views of other Deputies.

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