Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I thank Deputy Louise O'Reilly for bringing the motion before the House. As the Minister, Deputy Harris, has outlined, the Government will not oppose the motion.

I want to comment on some of the remarks before I deliver my speech. Deputy Joan Collins referred to the killing of Sláintecare. I assure the Deputy that the Taoiseach, Ministers and the Government are committed to Sláintecare. Deputy Harty relayed a story about a man who has been diagnosed with cancer and has not received the necessary treatment for the last four months. I will certainly raise that with the Minister, Deputy Harris, when I see him this evening. As for Deputy Mattie McGrath, what can I say? I do not know whether to be amused or bemused, to be honest. I know where my moral compass is and I do not need anybody in this House to tell me where it should be. As for where the Minister has fled to, I cannot comment on that as I have no idea.

All Deputies have spoken from the heart, which I would expect on an issue such as waiting lists and people attending accident and emergency services. I am somebody who has experience from recent months of the importance of having accident and emergency departments where people can be taken in emergency situations, given I had to go there on Christmas morning with my husband. I was taken aback by the fact there were only six people in the intensive care area on Christmas morning, with the patients waiting in cubicles. I am not sure if that happens every Christmas but it certainly happened last Christmas.

The reduction in the number of patients waiting for a hospital procedure over the last ten months, from 86,100 in July 2017 to 78,600 in May, is significant. The target of below 70,000 by the end of the year is equally significant and demonstrates that investment in our health services, in combination with a solid implementation plan, will deliver results. Regarding the request to properly invest in our public health system, I draw attention to the fact the Government has committed a record level of €10.9 billion in the national development plan to the health sector over the coming decade. This is building on the momentum of past years, where the Government increased funding for health services each year since 2013, totalling a 19% increase over the period. A Programme for a Partnership Government commits to sustain these increases.

Investments in budget 2018 were closely aligned with the recommendations in the Sláintecare report. New initiatives included investing €25 million in a new primary care fund, additional funding of €25 million for home care and transition beds, €17 million to reduce medicine and prescription charges, €75 million targeted to reduce waiting lists and €1 million for the Sláintecare programme office.

The demand for nearly all health and social care services is growing, primarily as a result of overall population growth and the ageing of the population. This trend has been demonstrated by analysis from the ESRI last year and the Department's health service capacity review 2018. The review stated that the system will need nearly 2,600 additional acute hospital beds by 2031. The Minister has asked the Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for winter 2018-19.

As outlined in the capacity review, the demographic pressures being experienced by the health service are such that they demand not just additional capacity but also continued emphasis on health and well-being initiatives, an improved model of care with a stronger role for enhanced community-based services and continued improvement in productivity, including in acute hospitals. Importantly, the accelerated introduction of additional capacity for 2018-19 will be matched by forthcoming reforms, including the publication of a detailed Sláintecare implementation plan and the overhaul of the current GP contract.

In addition, a review of the winter initiative 2017-18 is being undertaken which will inform a three-year plan for unscheduled care and support the provision of additional capacity in winter 2018-19. The Government is committed to investment in additional capacity in line with the national development plan which includes provision for 2,600 acute hospital beds, including three new elective facilities, 4,300 community care beds, diagnostic hubs in the community and the roll-out of e-health infrastructure across the health system. Work is also under way to identify the number and location of additional beds that can be opened and staffed in 2018 and into 2019. This increase in capacity is at the centre of future-proofing our health system.

One way to increase elective work is through the provision of new dedicated ambulatory elective-only hospitals as proposed for Dublin, Galway and Cork in the national development plan. The introduction of these dedicated day and ambulatory centres is in line with health care developments internationally and the recommendations of the 2018 health service capacity review. They should both increase capacity in the hospital system and provide a better separation of scheduled and unscheduled care. However, investment and reform must go hand in hand.

The Sláintecare report and its recommendations will transform how our health system functions in the very best interest of patients. There is the opportunity for many of the patients who are currently waiting for an appointment to a hospital outpatient clinic to receive care in the community. Early intervention in the community can play a key role in reducing the number of patients referred to acute hospital services. There has been continued investment in the primary care sector to enable people to be treated in their communities or at home and 118 primary care centres are now operational across the country. Of these, ten have opened in 2018 while a further nine are scheduled to open before year end. These centres provide modern, well-equipped infrastructure and are central to the effective functioning of multidisciplinary teams providing a range of therapy and other services on-site. There is also the opportunity to ensure that patient stays in hospital are as short as is clinically necessary and that facilities in the community are available for patients who require them.

The implementation of Sláintecare provides the opportunity to transform our health services and to ensure access for patients to care when they need it and in the most appropriate settings. However, we must continue to take action to improve access to services. Patients receive a high quality service in our health system as confirmed in patient satisfaction surveys. The major challenge is to secure access to those services in the first instance. As the Minister for Health, Deputy Harris, outlined earlier, the Government is acutely aware of this challenge, is taking action to address it and welcomes and will consider proposed solutions from all Deputies on this important issue. I thank Deputy O'Reilly for proposing the motion.

See this speech in context