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

That is good to hear. I have met many stakeholders since my appointment as health spokesperson and there is one common thread - people talk consistently about the need for prevention. It is welcome that the motion mentions prevention, early intervention, self-management and primary care. It seems that across the service this is where we are falling down. Too often we allow situations to reach crisis point, leaving personnel fire-fighting and doing nothing more. We take our eyes off the bigger picture in terms of policy-making and budgetary processes. In the race to reach fiscal targets or as the HSE struggles to stay within budget, we long-finger important interventions and initiatives that could prevent crises from occurring in the future. It is easy to leave the health problems of the future to the politicians and decision makers of the future, but the committee should transcend that thinking. We need to spend mention on preventive care services and it is not just a case of throwing money at initiatives. How does one prevent children from needing multiple extractions under a general anaesthetic, given that they cannot access dental services while at school? How does one ensure timely discharge from hospital in the absence of proper community rehabilitation services, sufficient home care supports or access to therapies? In that context, it is welcome that we are discussing this motion. I welcome the establishment of the committee.

As a package of reforms, including the establishment of a committee on the budgetary process, there is the potential to frame a new dialogue, but there needs to be a blueprint and a plan. I hope, therefore, that the committee will not be just an exercise in electoral platitudes or photo opportunities. I will play my part on it and will be advocating strongly for acess to health care as a right. The model of universal health care Sinn Féin is working to achieve includes general practitioner and other primary care services. Quality of care is essential and must be at the heart of the service. Such a new comprehensive system will not be achieved over night, but a start must be made. That requires political will and a fundamental change in the direction of policy, away from the piecemeal, inequitable, semi-privatised and crisis management approach that has perpetuated the many problems in the health service. How this debate will be framed, how we move beyond the dominant political ideology of recent years which has seen public services starved of funding, how we report, present and act will be the litmus test of the success of this parliamentary exercise. We need to be honest with ourselves. When agency staff cost more than the staff directly employed, regardless of whether we have an ideological bent towards the market and market forces, we need to be able to say the use of direct labour is right, more efficient, cheaper and represents better value for money for the taxpayer. It is not good enough to say a hospital can recruit if it has the money. If it does not have the money, a moratorium is effectively in place in the health service. That is happening and needs to be addressed.

Six months from now the real work will begin. The committee will deliver a vision for the health service. Delivering on it will be the biggest task facing the Department, the Minister and future Governments. Many people are depending on us. We cannot let them down and should not sell them short.

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