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

I wish to start by thanking Deputy Shortall for proposing this committee. It was a good idea and the fact that it was embraced by people from all parties very quickly is a testament to that. Nonetheless, it did take someone to start the conversation. On behalf of myself and my party, I thank Deputy Shortall.

I wish to reiterate what I said only a few short months ago on the establishment of this committee. 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 for the Irish State. However, as it was then, it still is now, my grave concern with this process is that the report, the recommendations, the expert opinion, potential models and stakeholder engagement will be discarded if it is seen to run contrary to the Minister’s agenda for health, as stated in the programme for Government. Can the Minister advise on whether this is going to be a worthwhile exercise? I hope that we are not tying members, stakeholders, academics and others into a process that will have a few days airing in the Dáil but ultimately end up being consigned to a library.

I note the Minister's comments on primary care being a building block and I would not disagree with him on that. While we are discussing the importance of primary care and the need to focus on it after having hearings about it, the bricks and mortar are going into primary care but the staff are not. The Minister, I am sure, will be aware that Sinn Féin has repeatedly questioned his Department and the HSE on this and they keep coming back with the same answer as to the number of additional staff that are going to be supplied for the primary care centres. It is a nice easy figure to remember: it is a nice big round zero every time. That is not good enough and does not fill me with hope that the report of this committee will be adopted.

Yesterday, our committee continued its hearings as part of our work plan and work stream. We were fortunate to have taken part in a video conference with Professor Allyson Pollock, who is an expert on universal single-tier health systems and who could draw on the experience of the NHS to point us in the direction that we should take our health system. One of the most striking points that she touched on was on the issue of hospital trusts, the various experiences in England, in particular, and how the establishment of these trusts may actually be detrimental to the establishment of a universal single-tier health system.

In that regard, I was struck by how her comments and warnings on these trusts needed to be heeded in terms of the programme for Government. To refresh Deputies' memories, some of the pertinent parts from the programme for Government document in this regard are:

We will advance progress made on Hospital Groups before strengthening their capacity to be stand-alone statutory Trusts. Hospital Trusts will gain greater autonomy (own their own assets, manage recruitment) while also ensuring accountability... Hospital Groups/Trusts will be required to develop strategic plans to re-organise services within their group of hospitals... We will provide for the temporary transfer of management of hospitals to another provider where there are consistently poor outcomes, patient experiences and financial management... Service providers who fail to meet their targets, and who do not fully engage with the new Unit will be obliged to use their own budgets to ensure targets are met with the assistance of private sector providers.

The Minister is smiling because he knows exactly what is coming next.

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