Alan Kelly (Tipperary, Labour) | Oireachtas source

I congratulate the Minister. It is pretty rare that a spokesperson moves straight into being a Minister, particularly one taking over from his neighbour, so there is an additional dimension there. I wish him the best. We in the Labour Party will support him during the pandemic and when we agree with him. When we disagree with him we will oppose him. I very much welcome the fact that he will do questions and answers. That is a good change. I also welcome the precedent he has set here with various Deputies, starting with Deputy Murnane O'Connor, of offering briefings from officials on specific issues. I presume this offer applies to each and every one of us. I have a number of observations and questions. The Minister might answer the questions in whatever time he has.

What we are doing today we are doing a bit blind because, due to the way in which the Estimates are put forward, there is no linear capability or way for us to see where money will be spent. That is partly understandable but obviously not acceptable, and the Minister would be the first to say so if he were standing here, so that cannot happen again. He said when he was in opposition - and he will hear that quite a lot over the next few months and years - that he would set up an office for budgetary management. He also said he would hire quite a number of forensic accountants across the Department. I presume both of these things are happening. He might verify firstly that he will do these things because he was very strong on them, to be fair to him.

We need a plan for reopening the health service. The HSE has published a kind of strategic framework for delivery, but it has not published a full clinical roadmap. When will we get that? We have been waiting a seriously long time for it. The Minister said on 11 June that screening was not being restored quickly enough, so I presume he has now put in place plans to accelerate screening. Will he give us some details on changed dates or quicker dates? Given my track record, I am certainly not happy with where screening is at the moment and how it will be rolled out.

Today's motion will add €2 billion to the budget. We will support that but we also need to see, first, what the percentage is of services that are not being utilised and, second, what budgetary saving there has been. We know there are mental health services, disability services, community services, etc. We cannot see what percentage of the budget has not been used on all of these and where it has not been used. Could we have a breakdown on that?

Could we have statistics on what private hospitals provided during their period under State control - the numbers of procedures, the costs, etc., by location? Post Covid, what will the Minister change in regard to information provision from private hospitals into the national statistics? When he was in opposition the Minister complained quite rigidly about the lack of conformity in that regard.

I totally disagree with the Minister on the NTPF. What is his plan for its use? Does he envisage that during his tenure as Minister over the coming years, we will not use the NTPF? How does he believe we will use the NTPF over the next year in particular?

We all know there is a huge issue with bed capacity. The Minister felt 2,600 beds needed to be put into our public health system. Obviously, he has not even been in the job a week, but will he provide an initial analysis of how he will make that provision and over what timelines?

Will the Minister undertake to conduct a cost-benefit analysis on nationalising existing private hospitals versus new build? We need to do new build as well, but would it not make more sense to nationalise one of the larger private hospitals in order to create public capacity? Has a cost-benefit analysis been done on that? We are spending 20% more than the EU average on healthcare, but our public healthcare system is still underfunded. This is clearly down to duplication between public and private healthcare, and this is a huge inefficiency. The Minister comes from a management consultancy background. We all supposedly agree on a one-tier health system and Sláintecare. How does he intend to address that?

What are his plans and what outcomes will he deliver in his first 100 days as Minister?

What is the Minister's position on the de Buitléir report? The former Minister for Heath, Deputy Harris, who is Deputy Donnelly's predecessor and neighbour, on numerous occasions asked him this question. Many of my colleagues and I were very clear in our support of the report. What is Deputy Donnelly's position now as Minister?

We are very dependent on overseas medical staff, as the Minister knows. I think 3,000 non-Irish staff, who do fantastic work, registered in 2017 alone. We will have challenges in this area. What plans does the Minister have in this regard? While I am at it, I compliment the makers of last night's fantastic documentary. It was amazing. The Minister has committed to providing 5,000 more doctors and nurses in the public health system. Where will he source them? Will he undertake to bring a report to the House on the labour force implications of Covid-19 along with a plan for the future staffing of the health service? This could be done in conjunction with his predecessor, who in his new role would be able to help him with that. The Minister has made very public commitments on ending the different pay grades of consultants. He very publicly said when in opposition that he would do this immediately if he became Minister. When in 2020 will this difference end?

What is the latest status of the children's hospital and the finances surrounding it? I do not expect the Minister to have the figures off the top of his head but I would like to know. Has anything in the service delivery plan been affected from a capital point of view because of Covid? I have already asked the Minister's Department about this and it could not provide answers, so perhaps he could.

Will the Minister consider rolling out a full flu vaccine for everybody? I believe, and my party has put this forward numerous times, that this would be the most appropriate thing to do over the coming years.

The Minister said quite publicly that he would find €20 million extra for disability services. When will that be put in place?

Disability services are completely and utterly underfunded. We have a situation in Carrick-on-Suir in relation to St. Brigid's District Hospital, which is an amazing place that provides respite and palliative care services. It was taken over as a stepdown facility for Covid services. This is an example of another service that was taken over but is at this moment no longer used or needed for Covid care. When will it be released to do the work it did fantastically beforehand? I would like a specific answer on that service and similar services across the country.

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