Eamon Ryan (Dublin Bay South, Green Party) | Oireachtas source

This is a useful debate. Our most significant budgetary categories are social welfare, health and education. They reflect the three big Departments where the money goes. Our history over the past 15 or 20 years, including in the lead-up to the crash, shows that most of the money went into these categories. Expenditure on health increased dramatically in the period. Obviously, we have experienced a particularly harsh and difficult time in the past seven or eight years as the budgets came down again. They are starting to expand, which is welcome, because our economy is starting to grow but we should be careful to avoid the trap into which we fell in the early 2000s when we were just putting money into a system without getting value for it. We must be razor sharp and clinical in assessing the benefits of our health expenditure.

I am conscious that the Minister has a task ahead of him in conjunction with the rest of us in the Parliament as we are running our health system, or changing the entire system. I am very glad a joint Oireachtas committee is now examining how we can, in mid-flight, change some of the engines of our system to move towards a single-tier system. I do not see any of that set out in Estimates. This relates to one of the questions I was asking during Leaders' Questions earlier today. There is a need for detailed work in the committees whereby the Minister would outline, through his budgetary provisions for 2017 rather than through what we are discussing today, how he wants to make the desired shifts.

There are a number of other shifts I do not see in the spending priorities and on which I want to reflect and comment. Various Members have raised concerns about using specific examples to outline the problems at large. I am concerned that we are not allocating enough money for ICT. We are spending approximately 1%. When we invest in ICT systems — be it PPARS, electronic voting machines or Eircode — and the investment does not work out as originally planned, it becomes a big story. I fear that this freezes the public service such that it is afraid to take a risk or change the way it does business. Officials do not want to risk their career by suggesting some innovative ICT approach. We are not spending enough on ICT. The Green Party’s assessment of health policy is that we radically need to increase ICT expenditure because it may result in productivity in all the other areas where we are spending the money.

I agree with the comments of Deputy Stephen Donnelly on where the money is going. Parsing the figures as best I can, I believe the money is being spent on wages and staff primarily. Are staff being used to best effect? By investing in ICT, we can ensure our health and emergency systems and some of the processing in that regard are carried out in a more careful, creative and humane way. We could direct patients to where resources are under-used.

ICT investment would allow us to treat patients at home. It would allow us to change fundamentally the structure of the health system and the means of providing services, including through remote sensory systems, remote diagnostic tools and remote delivery of medicines. This is all available. We have most of the leading companies in this country that are interested in this space and which are good at what they do in this area. We should be using their expertise. We are not budgeting sufficiently in this space. I flag that for the Minister.

I wish to give a personal example. We have all used personal examples. One of my strongest memories concerning the health system is that I was once invited to an event by the great Risteárd Mulcahy, the professor of medicine in UCD and cardiologist in St. Vincent’s. I was once very proud to be involved with him on a cycling campaign. This is a very important example of preventive activity in the area of health in which we need to invest. Creating a healthy environment will actually cut the budget more than anything else. Professor Mulcahy brought me to the preventive centre in St. Vincent's. It may have changed since my visit was a number of years ago. I will always remember walking through long corridors with massive machines and considerable resources only to finally arrive at the centre of preventive health in the hospital. It was a broom cupboard. That is the only way to describe it. We now have the opportunity not only to put funding back into the health service but to reform it.

The Minister should push preventive medicine, the use of information and communications technology, residential care and community design systems. I do not see this being done and it is the Minister's job to change it.

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