Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

Cuirim fáilte roimh an díospóireacht anocht. It is very opportune coming after the many debates and discussions we have had on health recently, including Deputy Pringle's motion last Tuesday on personal assistance.

Today we have so much knowledge and awareness and we know what to do, why we should be doing it and how to do it, but the problem is implementation. We have theories, visions and principles that sound lovely. Deputy Harty's comprehensive briefing outlined today that the Department of Health's strategic objectives allude to supporting people to lead healthy and independent lives. Sláintecare sounds so lovely, as do "universal single-tiered health and social care system" and "equal access to services". There is a wonderful phrase, "based on need and not ability to pay". When we move to the questions of accountability, goals and timeframes in which to achieve goals, however, there is a totally different scenario. Every Deputy knows the reality of this. We are all being contacted about it. My most recent case in this regard was raised by a married couple in my constituency. The man has been diagnosed with a rare disease. The couple's problem is the lack of clear information from the HSE, the consultant and the registrars. The word the couple used about the attitude towards them was "patronising". The couple does not want to be bumped up the list; they just want clear information on their current situation. That is not taking from the excellent care patients get in the system. There are examples of best practice but they are not universal.

We live in a democracy. Equality is supposed to be the cornerstone but citizens and other residents are not treated equally. This is what Deputy Harty's Bill is trying to address. The inequality begins long before the person gets to the doctor, hospital or clinic. We have the statistics and reports that show that one's socioeconomic background has a major impact on one's health and life expectancy. This is very evident in parts of my constituency. The Bill is trying to address that by focusing on equal rights, affordable access and the common good. This is connected to the point on healthcare and healthy conditions. The reality is that there are so many living in unhealthy conditions, overcrowding, dampness and unhygienic conditions, not to mention the particular health needs of certain groups, such as Travellers in certain types of accommodation and rough sleepers.

An example I know so well concerns people with an addiction who want to take the first step towards recovery. If they have private health insurance, they get quicker access to residential treatment. Without it, it is a different matter. We are aware that the projects in the inner city are doing so well. The Minister for Health, Deputy Harris, was in SAOL recently. Soilse, Crinan and Chrysalis are all on reduced budgets that have not been restored. The Recovery Academy has a wonderful event every year on Merrion Square. It is so uplifting and positive. Once one person gets into recovery, the knock-on effect on the family and community is unbelievable. There is a payback for others who are trying to get into recovery.

Sláintecare and the strategy require something like Deputy Harty is proposing in order to turn the visions and objectives into reality. It is incredulous that we are having this discussion in a country that is relatively wealthy, that has a thriving economy and that has a relatively small population. It is unbelievable that we have not got it right for everyone. Constitutionally enshrined rights to health and to realise the vision are required.

The Bill has been crafted carefully to prevent punitive legal proceedings. Transparency is central. The onus is on the State to explain its inactivity. It is really about being proactive, not reactive.

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