Michael Harty (Clare, Independent) | Oireachtas source

I would also like to echo my appreciation and thanks to the chairman of our committee, Deputy Róisín Shortall, who did an excellent job in keeping us all together and encouraging us throughout the 11 months the committee sat to draw up this report. I also thank the secretarial staff and those who helped us from Trinity College. They were essential in getting this report completed almost on time. We took a little longer than anticipated but, as the Minister will appreciate, it was a mammoth task.

We approached the report with pragmatic idealism. We understood this is a very complex and difficult task but we were idealistic in our outlook and we also realised the complexities of what needs to be done. We know the way things are but we want to see them how they should and could be. We have to see where this health service is at at the moment and why we need reform because the current system is not fit for purpose. It is fragmented, disjointed and incoherent. There are some areas of the health service that work very well and work to a high level of excellence but they also struggle like the other areas of the health service that are struggling for resources, capacity and staff.

It is quite obvious that our system is under severe stress when we see the ever increasing waiting lists for outpatient appointments, elective inpatient care and urgent inpatient care and waiting times in our accident and emergency departments.

An emergency department opened in Limerick hospital three weeks ago. It still has the same number of trolleys in the new department as it had in the old one. There was never any expectation that that would change. We need to look beyond a piecemeal solution to our health service. I understand that we cannot believe everything we read in the newspaper, but I was concerned to read that the Minister was looking at the elements of the report which complied with Government policy. I hope that is not the case because this report must be looked at in its entirety. As Deputy Shortall said, it is not a report from which one can pick and choose areas that comply with Government policy because Government policy is not working. If we were to comply with Government policy, we would get nowhere. The central part of this reform programme is integration. The report must be looked at and studied in its entirety, because one cannot integrate fragmented, piecemeal structures. Integration is a large chapter in this report and it is central to it, because unless the report is looked at and implemented in its entirety, then the integration component means nothing.

It is a roadmap and a blueprint. We are not saying it is a perfect report and it will have flaws. If each member had written the report on his or her own, he or she would have written a slightly different report, but it is a consensus report. It must be looked at in its entirety. When the health system is reformed in its entirety, sequenced and phased properly, and properly integrated, we will have a health service that is more efficient, much more effective and cost-effective. I agree that pouring money into our broken health system is not a good idea. This is a ten-year blueprint for our health service. It needs to be studied seriously by the Government. I hope the Minister will accept it, not necessarily every word of it, but the direction in which it is going, which is a universal, single-tier public health service delivered on medical priority need, not on the ability to pay. It is a short sentence but requires a complex reform programme by which it would be delivered. It must be looked at in that way.

Delaying reform is not an option. We are at a crossroads and we demand that this health reform begins. I am delighted the Minister has continued in his office because the lack of continuity in the health Ministry would have been disastrous for this report. He now has the opportunity to adopt reform during his tenure. Reform should be the word he looks to each morning when he wakes up, and he should ask himself how he can reform our health service. This is critical. It would be of great import if the Minister came out with the statement, "I intend to reform this health service, and I intend to start now." If the Minister made that statement, it would improve the morale of the staff within the health service and it would make people looking for health care positive that something was going to change. It would be important if the Minister could make a statement like that.

The Minister also needs to speak to front-line staff. I know he says he has visited almost every hospital in the country.

See this speech in context