Enda Kenny (Mayo, Fine Gael) | Oireachtas source

The Cabinet sub-committee deals with a range of issues about health, whether general expenditure, the HSE implementation plan, the development of concepts such as money follows the patient, strong primary care and community systems, the hospital groups and their development to a point where they will make recommendations in due course about services and how best they can be provided, the complicated procedure that followed the announcement of the development of the national children's hospital, the Central Mental Hospital and the National Maternity Hospital going to St. Vincent's University Hospital, the development of primary care centres, of which there is one per month, the constant challenge of reducing agency costs for nursing, and the challenge arising from the Haddington Road agreement and general pay agreements. These are all issues plus other relevant features of the health system, including Healthy Ireland, the change in the nature of treatment of many issues, the development of new drugs, and dealing with drugs companies and costs. These are all part of the work of what is truly a massive organisation, between the Department of Health and the HSE and all those who work for it. They are the areas at which the Cabinet sub-committee on health looks.

For instance, the concept of the development of universal health insurance from beginning right through to fruition is something that may take well into the second term of government before it is realisable. One must have the money following the patient, a strong primary care and community system and the hospital groupings all in place before that can happen. There are issues of insurance, costs and private health insurance and the necessity to have more people understand that they can enter this system much earlier than heretofore, thereby helping everyone.

Of all the Departments of Government, Health is one that affects every single person in one way or another and every single household. The Minister's challenge is to stabilise the health system in order that it can deliver the results we expect at the front line while at the same time manage it to a point where the evolution of universal health insurance, the development of the hospital groups and the provision of services throughout the country are in the best interests of the patient. The patient must be central to this.

It is not an easy issue to deal with in terms of contracts, renewal of contracts, the GP services for those under six and for those over 70. These are all elements of work which the Minister is overseeing. As a Minister who is new to that Department, he must have time to get a grasp of the priority issues with which he has to deal while at the same time seeing how costs can be contained in a massive Department where the situation is demand led and where it is impossible to determine what the scale of demand might be as it depends on the issue that might arise in any part of the country.

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