Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I thank Deputy Naughton for sharing time. This is an important report and I was happy to be a member of the committee. A tedious process had to be gone through but everybody agreed there was a serious need to overhaul the delivery, manner and methodology of our health services. Many experts gave opinions during the committee's hearings and I acknowledge their work and the work of the chairman, Deputy Shortall. She stayed with it and it would have been easy to give up and walk away. The views of the witnesses were hugely important because, in many cases, they presented the views of the people who had direct access to the requirement for the health services in one way or another. It is always important to take account of their views.

I agree with the report in general, while acknowledging it will be expensive to implement. However, it is important that the building blocks put in place to address this issue complement one other. We cannot afford to have an intervention that goes in a particular direction only to find that it does not work two or three years down the road meaning we have to go in another direction. That is how the health service has operated for several years. There are many deficiencies and I am a great believer in the notion that these can be identified mathematically in every area and remedied rather than using a broad-brush approach to secure as much funding as possible and throwing it at the system. That does not work. The report has highlighted the need to identify those deficiencies and to address them in a methodical and complementary way. The Minister may well have said initially that the report will be expensive to implement and we will not be able to do it all in one day. It will take a number of years but the critical issue is that whatever happens should remain in place for the duration and additional funding and operational changes should complement those interventions in a meaningful way.

It is about time we stopped kidding ourselves about where the deficiencies are and so on. They need to be identified. For example, we need to work out simply why there are waiting lists. This question was posed many times during the hearings. Various reasons were put forward, including nursing and consultant shortages and accommodation and capacity issues, as well as the ageing population, allegedly. At the same time, I note we have a relatively young population in comparison with other European countries. We have a much better youth profile than most of them. I do not buy into the notion that our ageing population is a serious issue coming down the tracks. While we have to address it, we do not have to do so to the extent that has been posited.

The committee discussed the dual system at length because it has dual costs and expenses. Ultimately, the public and private systems weaken each other and we would be better off with one or the other. The report recognises the purpose of the exercise is to provide a public health service that is accessible, dependable, modern, effective and efficient. If we do that, we will have done a great job. In addition, it must be recognised the current costs and the capital costs must go together. They are expensive and will require embellishment as time goes by. Deputy Kelleher mentioned the costs are as good as can be expected at this stage. No matter what one does, there will always be factors - events, as a famous man once said - which will affect the outcome.

The public will buy into something they believe is worth buying into. They will support something they believe will happen and to which they contribute through direct and indirect taxation. They will support it in the clear knowledge that by doing so, they will support their own interests. The private health system must be acknowledged and it does some good work. However, that cannot be done at the expense of the public system.

We must come to a juncture. It is somewhat like the housing issue in that we can spend as long as we like playing around with it on a day-by-day and year-by-year basis in a minuscule way but at the end of the day, we will all be dead before it will be addressed. It is important to identify the starting point and the initial shock that has to be experienced to clear the waiting lists and get the system moving. That is possible and that is provided for in the report, which is good. When we get to that stage, this report will have done a major service to the people of the country and the health services, in particular. By supporting the report and making it work, all political interests will have done a major service to society, to themselves and to the future development of the health services. We discussed the cost of medicines, hospital costs and so on but when people realise we are serious about we are doing, they will also make a contribution in every way through the different portfolios, which will be meaningful, effective and beneficial to all.

See this speech in context