Michael Harty (Clare, Independent) | Oireachtas source

I commend the motion to the House. I thank Deputy Róisín Shortall for tabling the motion and the Minister, Deputy Simon Harris, for accepting it. I also thank the 150 Members of the Dáil who signed the motion.

The Irish health service needs a long-term vision. It needs a framework that can build an efficient, effective and functioning health service. At present, unfortunately, in many areas our health service does not function properly. Year on year planning is not delivering an effective acute service. Our service tends to fire fight and respond to crises rather than anticipate crises and problems. Every year, we have a trolley crisis with up to 500 or 600 people per day on trolleys. This should be anticipated. Unfortunately, our trolley numbers are not falling back to zero at present and we continue to have people on trolleys. Today, 250 people are on trolleys but we are in the middle of summer. Each year, this situation deteriorates and the number rises to 500 or 600 people. We should build a service that can anticipate these problems and deal with them.

The HSE delivers some very good services. We have excellent acute cardiovascular services. I know the Minister of State, Deputy Halligan, feels there is a deficit in Waterford but throughout the country, and certainly in the mid west, we have wonderful acute cardiac services. We have wonderful breast, prostate, skin and lung cancer services. Our laboratory services for haematology and biochemistry are excellent. Our medical and surgical assessment units work extremely well, provided they are not used as an overflow for casualty during very busy times. These are very positive aspects of the HSE and we should recognise this.

There is a huge deficit when it comes to communication and integration between community and primary care services on the one hand and casualty and hospital services on the other. There should be a seamless transition between primary and secondary care and one of the most important areas the committee should examine is how we integrate primary and secondary care. This is the view of major medical organisations, including the Irish Medical Organisation and the National Association of General Practitioners. We are looking for solutions and accountability on planning decisions. Quite often, decisions are made in the health service which are devoid of input from those who deliver the service on the front line. This makes no common sense.

We must think laterally and differently about how we deliver our health services. In Ireland, 3% of the health budget goes on general practice. This needs to increase to approximately 10% over the next ten years, in line with other European countries. General practice is the engine which will deliver health care reform but, at present, general practice has severe capacity issues. GPs have suffered severely as a result of the financial emergency measures in the public interest legislation. They were affected disproportionately because of the manner in which general practice is funded. GP incomes were hit but funding to support and develop general practices was reduced by 38%, which is unsustainable. Many areas have lost GPs and many areas which still have a GP will find it very difficult to replace that GP when he or she retires. New GP graduates are not going into general practice because our contract is out of date and not fit for purpose.

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