Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

When we talk about the health service, it is important to acknowledge the many difficulties we face, particularly in access. They include people waiting for outpatient appointments or surgery or waiting to be given a proper hospital bed. We have real problems in access to the health service, but we should not ignore the many good things which happen in it every day. Life expectancy in Ireland is among the highest in the western world and improving because of good personal health and the health service. When Irish people are asked to rate their own health, they rate it higher than people from any other country. More than 80% of patients who are asked about their experience of the health service say they have had a good experience. One would not think it, but when people are actually asked what they think about the health service, more than 80% say they have had a good experience. Notwithstanding the real problems in emergency departments, two thirds of patients are either seen and sent home or in a hospital bed within nine hours. As a country, our patient outcomes are average to good. That is reflected in increasing cancer survival rates, fewer deaths from stroke and cardiovascular disease and other things. Even in recent years there has been a big uptake of vaccinations and a big reduction in the number of patients who contract MRSA. The Deputy will remember what a big issue it was in the past.

As the Deputy knows, there are two parts to the issue of waiting lists: outpatient waiting lists for those waiting for a clinic appointment and lists for patients awaiting surgery or a procedure, for example, hip, knee or cataract operations. In recent months we have really focused on inpatient day case surgical waiting lists, that is to say, for those awaiting procedures. In four of the last five months the number waiting for a procedure has decreased and we expect the figure to continue to fall. That is one of the areas in which we are making real progress. There are fewer people waiting for such operations. I accept that we have not made any progress on outpatient lists yet, but that will come.

To pick up on the Deputy's question on anticipatory reform, he will have seen the capacity review which was published only last week. It is very much an example of anticipatory reform. We are setting out the capacity increases we will need between now and 2031. We are not waiting until 2031 to do it. For example, 190 additional hospital beds have already been put into the system this year and there are now almost 10,000 doctors working in the public health service, the highest figure ever. We will continue to do this in the coming years.

On structural reform, the position of executive director for Sláintecare has been advertised. The Minister for Health has permission to establish a HSE board to improve the accountability of the HSE. I accept that that is a reversal of a previous policy, but bringing back a HSE board to bring about some accountability is the right thing to do. The boards of the hospital groups will be appointed quite soon and we are working on the GP contract. It will be difficult to do, but we are very keen to have a new contract. Cultural reform will be more difficult because in the health service it means taking on vested and local interests. Everybody wants to do it until they actually start to do it. We will need to see more tangible progress in other areas before we really get stuck into it.

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