Joan Collins (Dublin South Central, Independent) | Oireachtas source

There are many good proposals in this motion and I thank Deputy Louise O'Reilly for tabling it today. The issue of our health service is raised in the Dáil every couple of weeks because the agreed Sláintecare report, which received all-party support, has not been implemented yet.

Not only do we have exceptionally long waiting lists for medical procedures, the figures for which are contained in the motion, in recent months there has been a marked increase in the numbers of people who have gone into hospital for surgery only to have the procedure cancelled at the last minute. Patients are going off their medication, fasting and so forth only to have the scheduled procedure cancelled, in some cases two or three times. This seems to be a new feature of our health service.

I wish to concentrate on the key issue referenced in the motion, namely, the urgent implementation of the Sláintecare report. I was very disappointed to see that the summer economic statement published yesterday, which outlined the general approach of the Minister for Finance and his Department in preparing for the budget in October, makes no mention whatsoever of funding for Sláintecare. This follows on from the 2018 budget which contained not a single reference to Sláintecare. The whole emphasis of the summer economic statement was to maintain services at existing levels given the demographic pressures and to improve public services within existing allocations.

A key point of Sláintecare was the establishment of a national health fund. It called for a transitional fund of €3 billion, to be implemented over five years at €600 million a year, over and above the funding for the service in general. The report also called for €2.8 billion in ring-fenced funding to be provided over ten years to pay for expanded entitlements. Again, this would be extra funding for specific targeted entitlements and would be in addition to the funding needed to maintain the existing level of service. Sláintecare cannot be implemented without this ring-fenced funding and the proposed national health fund.

Sláintecare also set quite clear targets for action towards its implementation. The report proposed that a programme implementation office, under the remit of the Taoiseach, should be established in July 2017 and fully staffed by October 2017. It called for the appointment of an independent lead official and the establishment of a Cabinet sub-committee to oversee the implementation of the report. The reason for these measures were very clear: there was no confidence in the ability of the Department of Health to oversee and introduce the radical reform of healthcare that is envisaged in the report. When these measures were proposed, it was anticipated that there would be opposition from vested interests in the health care service and it was suggested that the authority of the Taoiseach and his Cabinet colleagues would be necessary to drive through these reforms. None of this has happened - quite the opposite. Despite the claims of the Taoiseach and the Minister, Deputy Harris, that they support Sláintecare, they have set up a committee in the Department of Health to respond to the report. If they want to kill Sláintecare, they could not have chosen a better way to go about it.

All the signs are that the Government will quietly shelve Sláintecare and pick certain aspects of it for implementation. The Minister referred in his speech to elective hospitals and electronic health data, which were proposed in the Sláintecare report. The report, which received widespread support in this House, represents a once-in-a-lifetime opportunity to give the people of this country a modern universal healthcare system that is fit for purpose. If the State fails to take its responsibilities seriously and bends the knee to vested interests, that opportunity will be lost and history will repeat itself. It was proposed in Sláintecare that legislation setting targets for phased reductions in waiting times over five years would be introduced by spring 2018. It was suggested that waiting times for inpatient procedures would be reduced to a maximum of 12 weeks, for outpatient appointments it would be reduced to ten weeks and for diagnostic tests it would be reduced to ten days. The proposed target for waiting times in accident and emergency units was four hours. That legislation was supposed to be introduced in spring of this year. How long will we be waiting? Is it going to be shelved again?

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