Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I commend Deputy Harty for tabling the motion. It is a matter of deep regret that almost 12 months after the publication of the Sláintecare report, so little progress has been made. There have certainly been plenty of positive noises from the Minister but actions speak louder than words and, unfortunately, the level of action from the Minister in this regard has been very disappointing.

Sláintecare is a fully costed, cross-party, ten-year plan for the reform of the health service. It represents a once-in-a-lifetime opportunity to do something of real significance in regard to our health service and to ensure that Irish people, no matter how much they have in their pockets, should once and for all have a legal entitlement to a proper public health service. We are on our own in Europe in terms of not having a universal, single-tier health service and it is not before time that we start to implement one.

The priority in the Sláintecare plan is for prevention, early intervention and a strong emphasis on primary care. We need to improve access to end the shocking current situation where we have an inverse care law, whereby those most in need of health care are least likely to get it. We also have an extremely hospital-centric health service and, for that reason, Sláintecare calls for a reorientation of the health service away from hospital care, with a strong emphasis on primary and community care. In that way, of course, we would get much better health outcomes, as well as much better value for money, and it is also what patients want.

The committee was very strong on the question of implementation. We did not want this report to be yet another report left to gather dust and, for that reason, we were very specific in regard to the implementation plan and devoted an entire chapter to that. There was a very tight timescale set out but, unfortunately, there has been enormous slippage since the publication of that report. At least six months has been wasted by the Government dithering in this regard and not committing fully to the cross-party report. The intention was that there would be a Cabinet response immediately. Unfortunately, we still have not seen that Cabinet response. The Minister promised it before Christmas, then before Easter, then by May and he is now saying "shortly", but we still have not seen that response. The implementation plan, as others have said, was supposed to be drawn up by the lead executive, not by the Department of Health. If the Department of Health was capable of a reform programme, it would have happened long ago. It is important that the implementation office is entirely separate from either the HSE or the Department of Health if it has to have the strength and the power to drive through the much-needed reforms.

When we look at what is most important in the health service, it is a fact that we seem incapable of providing good quality services to our people. That is because the health service has traditionally been dogged by vested interests, which need to be tackled. Equally, there is no accountability within the health service and the HSE does not have an independent oversight board. Some 88 Members of this House voted to abolish the board of the HSE in 2014 so it is empty words from many people now, thumping their breast about the fact the HSE has no independent board. Some 88 Members of this House voted to abolish that so how did they expect there to be accountability? Accountability is also required in other areas - from the Minister, from consultants and from senior managers. All of that legislation should be put in place before a new CEO is recruited.

I want to make the point that what happened in regard to Tony O'Brien looking to take on a very well-remunerated position in a US pharmaceutical company was outrageous. It was even more outrageous that the Minister for Health approved that position and he showed very poor judgment in approving it. It is entirely inappropriate that the director general of the HSE should be serving on a board whose chairperson is supposed to be answerable to him as the chair of the board of the biggest hospital group in the country. That is an entirely inappropriate appointment as well and Mr. Thomas Lynch should be removed from that position if we are to have any accountability whatsoever in our health service.

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