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

On the appointment of unpaid parliamentary private secretaries, we have decided not to proceed. We are relatively slim on the Government benches in this Dáil, with only 56 or 57 Deputies, many of whom, if not most, are Ministers or Ministers of State. In a different context, however, with a larger or majority Government, there might be a case for giving Deputies some experience in the ministerial ranks, but it is not something with which we propose to proceed in the current Government.

Ministers of State are heavily involved in policy formation in the areas for which they are responsible. Almost all Ministers of State have a delegation order which legally prescribes functions to them, while others have a delegation letter from a Minister which assigns them certain areas. They are the lead people, therefore, in policy formation on those areas. They also engage with their line Minister on broader matters, as well as through the Cabinet sub-committee system, and Ministers of State often attend Cabinet meetings where relevant. At the Cabinet meeting on Brexit today, for example, the Minister of State, Deputy McEntee, attended for obvious reasons. This is not a new practice and it ensures Ministers of State are fully engaged in decision-making when decisions need to be made.

I did not have a chance to watch the documentary on Maurice McCabe over the past two nights, although I saw a few clips last night. I very much want to watch it from start to finish but, unfortunately, I have not had much time for television in the past couple of days given everything else that is going on. Between now and Christmas, I certainly intend to watch it from start to finish. From what I have heard, it is essential viewing for anyone involved in politics and public administration, as Deputy Burton said. I will make it my business, therefore, to watch it.

In regard to progress made in other areas, I must admit that progress on the electoral commission has been slow. It was discussed at Cabinet on Tuesday and I asked the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, and the Minister of State, Deputy Phelan, to get on with the job, the next step of which is to produce a regulatory impact assessment of the electoral commission.

However, that section of the Department has much work to do. It is also working on local government reform and the referendums that are pencilled in for next May on extending the franchise in presidential elections to all Irish citizens no matter where they live, as well as the plebiscite. They have a great deal on their agenda but I appreciate that the electoral commission has been on that agenda for a long time and there ought to have been more progress. The idea is that the electoral commission could replace the Referendum Commission, in effect having a standing referendum commission which would be useful as it would no longer be necessary to set the commission and then close it down each time there was a referendum. It would also have responsibility for issues such as the electoral register, and could take on responsibility for registering Irish citizens who live outside the State, for instance if they register for postal votes under the reformed franchise for presidential elections in the event that people vote for that, or for the reformed Seanad franchise. It is a constitutional requirement for Seanad elections to operate by postal vote which makes them expensive. That is something we ought to examine. It also might have a role in the regulation of political advertising and posters. The Referendum Commission will publish its report on the abortion referendum shortly. It expressed particular concerns that no body was regulating poster or online advertising, but we must always be careful that in regulating these areas, we do not infringe on free speech. We need to get that balance right. I would never make changes on those issues without cross-party consensus, and people will understand why.

We are making a lot more progress on Sláintecare. The implementation office has been established and it has a director, Ms Laura Magahy. On Friday, I spent two or three hours going through the implementation plan with Ms Magahy and the Ministers for Health and Finance. Many of the measures in the budget speak to Sláintecare, including the move towards universal healthcare, reduction in prescription charges, the reduction in the drugs payment scheme threshold, and an increase in the income threshold limit for the GP visit card so that more people pay less for healthcare. It is happening at a slow pace but we must do it at a pace that is affordable and ensure there is sufficient capacity in the health service to deal with it. Negotiations are under way with the Irish Medical Organisation on a new GP contract. Were we to reach agreement on that in the coming months, it would be a significant step forward.

The implementation of the bed capacity review is also under way with 250 additional hospital beds provided this year. I do not know how many will be provided next year but I hope it will be more than that. The De Buitléir report on whether we should, and how we might, remove private practice from public hospitals is near completion. That would be a radical step forward. Project Ireland 2040 provides €11 billion for investment in healthcare in new hospitals and hospital extensions. Some 120 new primary care centres are up and running and there is new equipment and ICT. The National Treatment Purchase Fund, NTPF, has been given a greater role in the management of waiting lists. Waiting lists in Ireland are not well managed. Through the resources it has been given, the NTPF, has made progress on waiting times for operations and procedures. The average person waits less than six months on a waiting list for an operation or procedure, but the waiting times remain bad for outpatients. However, there are more missed appointments than there are people waiting more than three months. That says a great deal about the need for more reform, as much, if not more, than the need for more resources, because in excess of 300,000 patients are waiting to see a specialist, whereas 500,000 appointment slots go unfilled. All those issues need to be managed centrally.

See this speech in context