Dáil debates

Wednesday, 2 February 2022

Healthcare (Transparent Payments) Bill 2022: First Stage

Departmental Meetings

1:52 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

I am sorry. On disability, I agree with the need for a more singular focus on disability. The Government took a decision to move disability out of the Department of Health and over to the Department for Children, Equality, Disability, Integration and Youth because it was felt that health was such an enormous area that disability was perhaps not getting a co-ordinated focus. The view was that we would move it.

Disability is wide-ranging. I was involved in the area for many years as Minister for Education and Science and we did a lot of good stuff. We were able to do it much quicker in the education system, in terms of special needs assistants, etc. I am of a view - there have been pilots on this - that therapists being in the classroom may be a faster way of getting access for children to occupational therapy and speech and language therapy. We have provided additional funding this year for more therapists in the health service through the progressing disability programme but that has created its own problems in terms of how it is being developed and progressed.

I hear what the Deputy is saying in terms of the Department of the Taoiseach co-ordinating this, and I will look at that. However, the Deputy will see from the list that the Department of the Taoiseach has been expanding over the years in terms of that co-ordinating role. He can see it in the range of issues involved, from policing reform to climate change co-ordination. The trend seems to be in that direction whereas, under the Constitution, we have functioning Departments whose primary responsibility is the delivery of services that fall within their remit. That is something the Oireachtas needs to reflect on too, as the Government is also doing.

We can keep on expanding. I notice now, for example, that an Oireachtas committee may produce a report and then non-governmental organisations will come forward on specific policy areas and all of them will recommend that the Department of the Taoiseach do this or that. The bandwidth or operational capacity is not there within the Department of the Taoiseach to do all of that. However, it can do so effectively on some key areas. In housing, there is a strong delivery mechanism chaired by the Secretary General of my Department which works with the Secretaries General of the Departments of Finance, Housing, Local Government and Heritage, and Public Expenditure and Reform to make sure there is a full-on public service response to housing across all Departments. Those delivery mechanisms can work. It worked spectacularly in the late 1980s for financial services in which there are now between 30,000 and 40,000 people working. That took a delivery focus. Likewise with climate change, it has to happen in terms of delivery focus. The key issue for Government to deliver is that cross-departmental co-ordinated piece. Departments should not work in silos but in a non-territorial way, if I may use that phrase, and just get things done. That is my constant agenda. I hear what the Deputy is saying in relation to disability and I will come back to him on that.

To respond to Deputy Calleary, there will be an expression of interest sought for the post in question when it becomes vacant in the public service, along with the traditional way that this post has been filled. I hear the Deputy's acknowledgement of the public service the current incumbent has performed over many years in different capacities within the public service on issues of key national importance, as well as international importance, for example, Europe, Brexit and Northern Ireland, the economy and, not least, Covid-19. We have a good public service in this country overall. It has its weaknesses and its challenges, but the public servants in this country work in a committed way for the benefit of the country. I want to put that on the record. It is important.

Deputy Paul Murphy raised the issue of a wage-price spiral. Wages have increased. As I said last week, if wages increase in line with productivity, that is okay. Those comments were made in the context of the cost of living crisis. The Government has to look at ways to protect people against what is undoubtedly a very serious issue now in terms of cost of living increases and do so in a way that is not inflationary but protects people's disposable incomes, particularly their access to the necessities of life.

In relation to the Department of Health and the Secretary General, I have been clear about this. The Executive took a decision on this from a different perspective, and looking at it through a different prism. The health arena needs absolute focus and significant reforms right across all layers. Of all Departments, it oversees an enormous budget and a range of other issues.

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