Enda Kenny (Mayo, Fine Gael) | Oireachtas source

The Deputy's comment in respect of an abandonment of the universal health insurance concept is simply not correct. The Minister and the Government have pointed out that the original target for the introduction of universal health insurance cannot and will not be met.

It is important for Deputy Boyd Barrett to understand that health insurance must be affordable before it can become universal. The Government has put in place quite a number of the steps that lead to universal health insurance and a single-tier system. The Deputy is aware that long-term community rating was brought in to encourage younger people in particular to take out health insurance so as to reduce and contain the cost for everyone, as well as putting an end to double-digit increases every year, which we have had for so many years. It was an important step forward in everybody's interests that the significant increases in costs every year would be reduced for everybody. There are a number of other measures that the Minister will bring forward in due course to make health insurance affordable for more people in future.

The steps in respect of those under six and over 70 are two important elements of the process leading to free access to GP services as part of the universal health insurance concept. The Deputy is aware that the primary care centres are being built and opened on a continuous basis and the reforms I referred to. These include the national children's hospital and the national maternity hospital, and all of these are very major pieces of health infrastructure. Changes have been introduced and money has been allocated for very specific purposes. As everybody has pointed out, it is not always about the extent of resources that apply. Many years ago, there were massive amounts of money being ploughed into the health system and it was inferior to what we have now. The management has a responsibility here, as well as the application of resources. One is not separate entirely from the other but the concept of having a well-managed and well-resourced health system should lead to a competent, professional managerial capacity in hospitals.

The Deputy mentioned Portlaoise and the tragic cases that occurred there. The Minister for Health went there and met the families and parents who lost their babies for many hours, empathising and understanding the difficulties that they had, and he has taken appropriate action since. The report produced by HIQA and its recommendations have been accepted in full. I outlined the details of some of the changes that have already taken place here in answer to questions recently. The fact that the Minister for Health took the time to go to Portlaoise and meet the parents was important in him being informed as Minister of the necessity to have a comprehensive response to the HIQA report. The Minister wrote to the director general of the HSE on 15 May, directing that a swift and targeted response be put in place by the HSE to the immediate needs of those parents and families, including, in particular, counselling and support, a case review and other facilities as would be appropriate. He has obviously requested a response from the director general confirming that those services would be operational by this week, 22 May, at the latest. He has asked for weekly updates from the HSE on progress on the provision of those particular services. The HIQA report, which is very extensive and independent, set out the eight recommendations and the Minister has responded by committing the Department and the HSE to their full implementation. The Deputy knows those recommendations.

With regard to a broader patient safety response, high-quality health care means care that is evidence-based, appropriate, timely, effective, efficient, equitable and patient-centred. All of these factors did not apply in many cases, as the Deputy is aware. Patient safety is fundamental to quality health care and the health system must be enabled to deliver safe care while at the same time balancing competing pressures in what is an ever-changing, dynamic and complex environment, as Deputy Boyd Barrett is well aware.

It needs to be acknowledged, however, that the delivery of health care can always carry inherent risks, as we are all aware, and the scale and complexity is without parallel in other sectors of business, as it is always difficult to determine what might or might not happen. It is clear from recent incidents and events that the capability of the Irish health system to prevent issues and manage patient safety is being challenged and has been found wanting. That is why the Department and the Minister accepted the recommendations from HIQA in full and will get on to implement them. Clearly, the movement of setting up the hospital groups, with committees to make recommendations, is another part of that. The overall level of services and what might be provided best in any hospital in any group or locality is a matter of a considerable importance. It has taken up a great deal of time over the years.

These are all part of what the Minister and the HSE are now driving to bring about structural changes that will allow for the very best level of care and attention to be given, with a patient-centred system. I do not accept the Deputy's premise at all of the abandonment of the issue of insurance. I have pointed out the reason young people have been encouraged to take out insurance, so that it should be affordable and it can reduce costs for everybody else. That leads, in part, to the introduction of the universal and one-tier health system, where a patient is central and treated on his or her needs, as distinct from resources.

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