Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the Deputy for his contribution and questions and I look forward to working with him. I agree that the structure of the Estimates is difficult to interpret. I have expressed myself on the record for many years on this. We need to find better ways of providing this information to the Oireachtas. One of the most important roles of the Oireachtas is to hold the Government to account on the money it spends on behalf of the Irish people. I struggled for years in opposition with interpreting this information. I commit to working with the officials and the HSE to improve that. The establishment of the Parliamentary Budget Office is useful but a lot more can and should be done. The programme for Government provides that this will be looked at.

The Deputy asked if the Oireachtas will have the opportunity to engage in more detail on the extra spending. It absolutely will. I will make myself available for that and I have no doubt the officials within the Department and the HSE will do so too. If the Oireachtas wants to engage in that through the Dáil or the relevant committees, there will be no issue. As I said earlier, I will be back before the House seeking additional funding. This €2 billion is for measures that have been taken to date to deal with Covid-19 and a lot more will have to be done.

The Deputy spoke about long-term spending on personal protective equipment. He asked whether we need to build a national stockpile or increase domestic production. At this point I would say that all options need to be examined. If there is a second wave or a different public health outbreak in the future, we do not want to be scrambling to get planes in from China. Given where the health system was, the HSE deserves enormous credit for what it did and how quickly it responded but we do not want it to be in that situation again. All options have to be on the table in that respect.

A question was asked about private hospital capacity and if we continue to hold an option on using such hospitals during the pandemic. The private hospital contract ends today. It was understandable why it came in, although issues with it were raised by me and by others in the House during the contract negotiations.

The reduction in capacity in the public system caused by Covid-19 is immense. We may need to leave 20% of beds vacant. People involved in scopes say capacity could be down by 50%. I heard one figure of 80%. Surgeons say that in some cases they can do half the number of surgeries. GPs can see fewer people. Our public health system therefore faces an unprecedented crisis triggered by having to respond to Covid. I think a challenge at the same scale is having now to provide non-Covid care in a Covid world. Again, I think we will have to look at an awful lot of options. The goal is not to have dependency on private providers; the goal is universal healthcare provided through the public system. In the short term, however, the public system has just lost a vast amount of capacity. Our obligation is to make sure people can get access to healthcare. The medium-term goal, not even the long-term goal, is that we transition as quickly as we can to full capacity within the public system.

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