Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I congratulate Deputy Finian McGrath on his appointment, and Deputy Simon Harris, who is temporarily out of the House. I also thank Deputy Shortall for her initiative in this area, which has been somewhat overlooked in some of the press statements, particularly those coming from the Government. I acknowledge her efforts to bring all parties together.

Everyone wants an efficient, fair and humane health service. Politicians from every political party and none have called for this in every single election since the inception of this State. However, what we have is a two-tier system in which individuals and families face years, if not months, of waiting for treatment or diagnosis. Trolley numbers have spiked and it is only a few years since Senator James Reilly, the former Minister for Health, told us we would never again see 569 patients on trolleys. The words were only just out of his mouth when the target was breached. Waiting lists stretch into years and medical staff, nurses and health professionals trained at home are leaving in droves due to poor working conditions.

Deputy Billy Kelleher referred to mental health services as the "Cinderella" of the health system but this is not a pantomime, it is very real. The people who depend on the mental health services and the men and women who deliver them have reached breaking point. Our health system is in a state of perpetual crisis. We all know people who have been let down and failed by the two-tier health system. We know people who cannot afford health insurance but have borrowed money to avail of private health care because they cannot bear to wait for as long as they are expected to. We know people who can neither afford insurance nor borrow for health care and who have to wait in pain and in fear. We have seen public patients with late diagnosis die where private patients survive. The tragic part of this is we know that this is now the rule in the Irish health system and not the exception.

This crisis can be boiled down to two key failings on the part of successive Governments. First, is a fundamental inequality in how patients are treated, differentiated on ability to pay and geography. Second, is the sheer incapacity of the system to deal with demographic pressures, evidenced particularly in our emergency departments and in maternity care. No two patients are identical. However, some pay more than others for the same care. Families in one part of the country get access to necessary services denied to those in a different HSE region. The less well off die younger and live less healthy lives. This is not acceptable. Inability to pay should not deny anyone the opportunity to lead a full, long, healthy life. We need to increase investment in the health system, not simply to provide more resources and capacity but to directly challenge and eliminate these structural inequalities. Building adequate capacity across our health system and eliminating the unequal barriers to access will require significant and sustained public investment. Sinn Féin is committed to the realisation of a world-class system of universal health care, accessed on the basis of need, free at the point of delivery and funded by progressive taxation.

The task we face in the coming period will not be an easy one. The clock counts down from the moment of our first meeting and we only have six months to present a report, which is to be discussed in this House. Politicians have never been able to agree on health across the decades. If the members of the committee can agree a strategy in six months it will be a miracle but we in Sinn Féin will work hard to ensure that the committee does its work efficiently and in a spirit of co-operation. The internal dynamics of the committee and the work it does are only one part of the puzzle. What happens after we discuss the report? What happens to the report, its recommendations, the stakeholder input, the expert opinions and evidence, and the possible funding models?

It was said that many Ministers for Health commissioned so many reports that one could paper the inside and outside of Leinster House with them and we do not need another report. We do not need another photo opportunity, another trip to the plinth to talk to journalists. My concern with this process is that the report, the recommendations, the expert opinion, potential models and stakeholder engagement will all be discarded if they are seen to run contrary to the Government's policy. Can the Minister assure us that this will not be a futile exercise in that regard? Are we tying up members, stakeholders, academics and others into a process that will just consign the report to a library afterwards?

There are very large parts of the programme for Government to which Sinn Féin cannot sign up. I will not sign up to an agenda for privatisation, whether it be outright or through the back door. This is completely at odds with the realisation of a universal health care system. If the Minister is serious about this committee coming together to work collectively on a vision for the health service, we must be clear that any moves to privatise the health service in the form suggested by the programme for Government need to be shelved. The committee cannot gain legitimacy and respect, or develop a comprehensive programme of work, if it is precluded from its work by contrary plans pursued by the Minister at the outset. It is important the Minister make a full statement on this matter.

This issue will not be easily addressed within the six-month timeframe. Many factors need to be considered, including the demographic profile of the population and its geographical spread, demand and what constitutes health spending. When we talk about prevention and early intervention, we must be cognisant that this will impinge upon other Departments, and that there needs to be a whole-of-Government approach.

It is not clear how the ten year plan will work with other Departments. There are broader social issues at play. Will the Minister of State convene a ministerial committee to reflect on the work being done by the health committee? Will other Departments be involved? We will propose that the Minister for Health in the North, Ms Michelle O'Neill, be invited to discuss adopting an all-island approach to health care delivery. I strongly suggest this be done.

See this speech in context