Hildegarde Naughton (Galway West, Fine Gael) | Oireachtas source

I very much welcome this debate and the proposal to establish this special all-party committee. It is past time some long-term structure was given to our health service. I will refrain from criticising the HSE and its predecessors for not putting in place such a plan. This is because for decades health authorities in this country have been chasing their tails fire fighting one problem after another rather than planning for the future. This fire fighting was the result of, in a circular but predictable way, a lack of any long-term plan for the health service in this country.

If a service is pared down to its most essential parts, as happened during the recent financial crisis, it becomes easier to see where the problems are. This is for another day, however, and the committee has ahead of it probably one of the most important jobs in recent generations. There is nothing more important where we stand now in 2016 than tackling our health problems. What is required now is political maturity and an ability to work together and not stick rigidly to fixed ideological positions. All that matters in any committee deliberations are patient outcomes and a process that leads to a modern, efficient and cost-effective service for everyone, notwithstanding their means.

I wish to make one point in this debate which will resonate with Deputies whose constituencies cover rural areas such as mine, or areas of the country outside Dublin. Yesterday, I saw a very interesting figure, that 41% of Irish people live outside urban areas. An urban area is defined as one with a population greater than 1,500. Dublin's population, city and county, is approximately 1.25 million. Dublin, therefore, has just more than a quarter of the entire population of approximately 4.65 million. I mention this because many Deputies in the House would feel the majority of the citizens of this country are playing second fiddle when it comes to infrastructural investment, particularly in health care. Dublin is bursting at the seams in terms of transport, a lack of housing and other areas. Billions can be invested in the cross-city Luas, an airport extension or new hospitals.

While I did not agree with much of what the former Secretary General of the Department of Finance, John Moran, stated in a recent article, some of it made sense. There is a huge lack of infrastructural investment outside Dublin. This is simply a fact. Health care is one of the most obvious areas. University Hospital Galway is shoehorned into the middle of a medieval city, with no room to park or to expand and no plan for the future except for necessary but short-term replacement building projects. It is supposed to be a centre of excellence but I would try persuading either the staff or the patients going through the accident and emergency department of this. Cancer patients have to queue for hours or even days to be admitted. I could go on and I am sure other Deputies have similar issues in their constituencies. In Galway, we have all of this and an underutilised hospital campus of 150 acres of State-owned land at Merlin Park, a few kilometres away from University Hospital Galway. This is an example of the issues the committee needs to examine. We badly need vision in our health service.

I do not for one minute advocate a one for everyone in the audience approach. I fully realise that expertise in a given field has the best outcome for patients if centralised in a specialist centre. I do not advocate a centre of excellence in every town and village in the country. What I advocate is that the committee takes a good hard look at the services offered, how and where they are delivered and imagine our health system in ten years' time. Imagine a system which does not have 90 year old patients endlessly waiting on trolleys, cancer patients endlessly waiting for admission or nurses and doctors at their wits' end trying to cope.

Earlier I stated the committee has a hugely challenging task ahead but it is one with huge rewards. This committee, and subsequently this House, have a generational opportunity to create a health service on which all our citizens can rely and of which they can be proud.

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