John Brassil (Kerry, Fianna Fail) | Oireachtas source

I probably will not need all of the time. I welcome the opportunity to speak on the issue. Like other speakers, at the outset I compliment the Trojan work done to date by our chairperson, Deputy Róisín Shortall, who has gone far beyond the call of duty to the committee. It is a pleasure to work with her and to see the work that is being done by every member of the committee. It is refreshing for somebody like me, as a new Deputy, to be involved with 14 people working together, all with the same objective, to produce what will, I hope, be a revolutionary change to the way we provide a health care system. Deputy Ó Caoláin mentioned the possibility of the committee being a talking shop, but that will not be the case. It will take political consensus to see the work through and to deliver on the recommendations of the report.

As other speakers have alluded to, the primary care element of the health system is critical and getting that right will play a huge part in the future of health care provision.

We have had many contributions to date from people involved in primary care, and it is becoming increasingly clear to me, and I hope to all the members of the committee, that if we get primary health care sorted out, get our doctors, practice nurses, physiotherapists, occupational therapists, pharmacists, counsellors and so on working and funded, the pressure that will take off the system further up the line will result in our hospitals and accident and emergency departments being able to function properly and general elective surgeries and so forth working. There is also the need for proper step-down facilities to look after people who are well enough to be taken out of hospital but not well enough to go home. A combined strategy on those fronts will result in a much better health system.

Regarding the funding of such and where we get it, many models and possibilities are discussed. There is talk about Canadian models, the UK model, the NHS system and the Scottish model and so on. We must look at the Irish model because no one health system in one country will suit another country. There was mention yesterday in our presentation of the Canadian model, which is basically a public health system which is free to all and in which each citizen is treated equally. A person's public health card allows for treatment in every hospital regardless of income or background. That is a fantastic system and certainly something that we should strive to achieve. However, on looking into the Canadian system further, such elements as prescriptions, dental care, home care and physiotherapy care are not free. I imagine that if we tried to adopt that type of model in Ireland, took away the medical card from people and told everybody they had to pay for their prescriptions, it just would not work. There is a need therefore to develop a model that is specific to Irish needs. We have the ability and the wherewithal to deliver a health care system that suits and will work in our country.

There is constant criticism about morale in our health system and our hospitals. We must reflect that many people in the health system do very good work, and sometimes that needs to be recognised. I will share my own experience a few weeks ago. My mother is elderly. I finished visiting her at the accident and emergency department in University Hospital Kerry at 2.30 p.m. on a Sunday, and by 6 o'clock she was diagnosed, in a bed and being looked after. She is now home, healthy and improving. Things like that happen every day, and that must be recognised in order that people working under extreme duress see the fruits of their hard work. I have no problem saying in the House that people who do such good work need to be recognised and thanked for it. It is up to us to provide the system and the funding that works for them.

The establishment of the hospital groups is something we need to look at very carefully. It seems like it might be something that could work. However, there seems to be no onus on the individual hospitals to work together. For example, in University Hospital Kerry, there is one geriatrician doing outstanding work. There are 13 geriatricians in Cork University Maternity Hospital. That does not balance up. Cork University Maternity Hospital, University Hospital Kerry, South Infirmary-Victoria University Hospital, Mallow General Hospital and hospitals in Waterford are all part of the one group. I do not think a geriatrician in Cork can be told that he or she needs to go to Kerry and assist with the lack of services there. We have to deal with that. We have to establish contracts with our consultants and doctors that make sure every part of our geographical spread is covered properly. Part of this work needs to ensure we take control and get proper cover and care in all parts of our country.

I look forward to the next three or four months. It is an immense workload. I hope we can get our work done in the timeframe allotted to us. It is certainly our ambition to do so. Nothing focuses the mind better than a deadline. I hope that when we report - I think our full report is due to be published before Christmas - we will get the consensus and the buy-in because difficult decisions will have to be made if we are to buy into this. Every politician in here will have to make some difficult decisions. I hope we are up for it. The committee on which we are working certainly is. I believe we will produce a report that can transform health care in this country. It is up to the rest of us to row in behind it and support it. From this time forward, I hope we can look back at this as the start of the time when we got our health services straightened out in this country.

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