Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank Deputies for their contributions to this debate on health service reform. We are all aware of the pressures facing our health service on a daily basis and it is important that we, as elected representatives, make the reform of our health service a priority in the months and years ahead.

The Minister, Deputy Simon Harris, has spoken about our commitment to health service reform. This Government has committed to increasing and improving the capacity and infrastructure of our health service. However, it is clear to everyone that expansion must go hand in hand with reform. The Sláintecare report gives us the platform for a coherent and ambitious reform programme. We are committed to working with all parties across this House and with the health service itself to make the vision outlined in the Sláintecare report a reality.

It is clear from the contributions from everyone today that health service reform is and will remain a top priority for this and future Governments. The last couple of weeks have revealed the trauma and agony that can face patients and their families when our health service does not work as it should. We can all agree we are united in our desire to deliver significant improvements, not just in the case of cervical screening but across the health service more generally.

The Minister set out clearly this evening the actions he and the Government are taking in respect of the issues that have arisen with the CervicalCheck screening programme in the last couple of weeks. The Minister has acted quickly and decisively. The announcement today of a scoping inquiry, to be led by Dr. Gabriel Scally, is an important step in getting answers to the many questions we all have. The Minister also announced today that the Government had approved the drafting of a patient safety Bill which will provide for the progression of a number of key initiatives including requirements in respect of mandatory open disclosure.

The issues that have been revealed in respect of CervicalCheck have happened against the backdrop of growing momentum for fundamental and wholesale reform of our health services. This culminated in the establishment of the cross-party Oireachtas Joint Committee on the Future of Healthcare and the publication of its Sláintecare report last year. Again, we are all united in the view that this provides a unique opportunity to bring about real improvements in our health and social care services. Earlier this evening the Minister, Deputy Harris, outlined the actions that have already been taken in response to the Sláintecare report. Claims that the Government has failed to take forward the committee's recommendations are simply not true. An implementation office is being established and a recruitment process for the person to lead that office is almost complete.

Legislation to introduce a governing board for the HSE will be brought forward this year and an independent group is undertaking an impact assessment of removing private practice from public hospitals - one of the key recommendations in the Sláintecare report. The group will report later this year and will provide essential guidance on how this can best be achieved. We know this will not be easy but it will be a fundamental step forward in bringing about a fairer public health service for our citizens. Finally, the Minister is committed to bringing his proposals for a Sláintecare implementation plan to Government in the coming weeks. This will set out a concrete programme of reform for the next decade arising from the report's recommendations and will include a more detailed programme for the immediate years ahead.

As the Minister of State with responsibility for mental health services, I am glad to say that mental health continues to be a priority area for this Government. It committed an additional €57.5 million for mental health services in the budget this year. The mental health budget now totals over €900 million, an increase of 28% since 2012. The Government has recognised the need to further develop early intervention mental health services for those under 18. That is particularly the case in light of the 26% increase in demand for CAMHS service between 2012 and 2016. A sum of €3.4 million has been provided for the recruitment of 114 assistant psychologists in primary care. Of these posts, 111 are filled. This will enhance the primary care response and help to reduce waiting lists for child and adolescent mental health services.

The Government remains strongly committed to modernising all aspects of our mental health services in line with the framework for Ireland's mental health service laid out in a Vision for Change. The implementation of a Vision for Change was undoubtedly affected by a number of factors since 2006. These include the changed economic context, public spending constraints and a moratorium on recruitment. I am pleased, however, that in recent years we have been able to increase investment in this area and significant advances have been made in the reconfiguration and delivery of mental health services.

Our focus continues to be on building the capacity of community mental health teams across all areas to facilitate the move from the traditional institutional-based model of care to a more patient-centred, flexible and community-based service. While much of a Vision for Change remains relevant, it is important to ensure we are addressing the current mental health needs of Ireland. As many Deputies will be aware, a process is ongoing to review and update the current policy framework. Developing and improving services for older people - a growing cohort of our population - is also a significant priority for the Government.

My experience of speaking to older people around the country, and of meeting with organisations which represent them, is that they want to live in their own homes for as long as possible. For that reason I am strongly committed to ensuring that older people can continue to live in their own homes surrounded by their family and friends for as long as possible. The Government is fully committed to the development of a new statutory scheme for the financing and regulation of home care in order to support the shift towards community services and help people live with confidence, security and dignity in their own homes for as long as possible.

Developing a new statutory scheme for the financing and regulation of home care will be an important step in supporting people to live with confidence, security and dignity in their own homes. This scheme will ensure that the system operates in a consistent and fair manner for all those who need home care services. An important milestone in this process was the public consultation which concluded in October last year. The response rate was very high, with about 2,600 submissions received. A report of the findings is currently being finalised and will be published later this month. Further consultation with stakeholders, including service users, will take place later this year.

However, we are not standing still in this area. While the new home care scheme is under development, the Department of Health and the HSE are continuing efforts to improve existing home care services. This includes the provision of an additional 754,000 home support hours in 2018. I would also like it to be noted that this Government recognises the outstanding work done every day by carers throughout the country and the need for further supports for those caring for the most vulnerable in our society. That is why we are committed to delivering new legislation in 2018 to enable people in receipt of full or half rate carer's allowance or carer's benefit to qualify automatically for GP care without fees.

Before I finish, I would like to re-emphasise a number of points made by the Minister, Deputy Simon Harris, this evening in respect of additional resources and capacity. As we have seen over the winter months this year, capacity across our system is constrained. While reform is absolutely essential, so too is continuing investment in our services. We know the additional pressures that will arise in the years to come as a result of an aging and growing population. I see this day in and day out in my role as Minister of State with special responsibility for older people. This Government has increased investment year on year for health services. It has committed to a substantial €10.9 billion capital programme to upgrade, modernise and expand capacity across all aspects of the health system.

The health service capacity review showed how much demand on our health services will increase over the next 15 years and made a clear case for the expansion of capacity in the system to meet this. However, I doubt that anyone thinks we should expand capacity around the current design of the health system. It is important therefore that increases in capacity go hand in hand with system reform in order to achieve the health system the people of this country deserve. The Minister, Deputy Harris, and I are committed to working with colleagues across Government and the political spectrum to bring about meaningful reform in our health services. As the Minister previously noted, development of the Sláintecare report, and the cross-party support it enjoys, is unprecedented in the history of the State.

As demonstrated by our debates here today, we all recognise how unique an opportunity we have to make sustained reforms to our system and therefore we must ensure the chance does not pass us by.

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