Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank all Deputies for their contributions. It has been a very useful debate. I have taken several notes and the officials and I will work to go through some of the thinking and some of the suggestions, particularly in the context of the upcoming budget. The programme for Government sets out the pathway for expanded access to healthcare. This is all with the singular purpose of achieving universal healthcare in our country. The measures being introduced in this legislation are intended to support access to care for those who need it and to make sure we have fair and affordable care. Abolishing the acute inpatient hospital charges for children under 16 is important but there is more to be done; I fully agree with Deputies on that. The Bill is focused on easing the financial burden for parents and guardians when bringing their children to hospital for care. That is why I am committed to putting it in place very quickly so we can get on with enacting it. I am also very keen to have the free access to contraception scheme in place as quickly as possible. That is why I propose to amend the Bill on Committee Stage. The proposed amendment will bring about the scheme so we can introduce it as early as possible. My intention is for the scheme to be live within the next few months.

There has been a lot of very good discussion this afternoon on universal healthcare. Universal healthcare is a very simple and profoundly important concept. The principle of universal healthcare very simply states that when any man, woman or child needs access to healthcare, whether preventative care or care when they get sick, they will get that care quickly, it will be good quality care and it will be affordable. That is it. There are three tests. As we all know, in some areas of healthcare we are there but in far too many aspects we are not. This is one of the most important unfinished projects of our Republic. For us to realise the Proclamation and the ideals of some of the people staring over us every day - those bronze busts and heads around this Chamber - we must achieve universal healthcare in this country. It can never be acceptable that the level of care a child gets could have anything to do with how much money their mum, dad or guardian makes. That is something we must also consign to history.

Significant progress is being made on our way to universal healthcare. We all know it cannot be done in one, two or three years. It is a huge project. Even if there was infinite money, we have to build up capacity and make changes that take years. A lot of progress is being made. I note some of the supportive comments that were made on affordability, which is the topic of this debate. We have reduced the threshold under the drugs payment scheme.

We are bringing in free GP care for six- and seven-year-olds, abolishing hospital charges for children, bringing in free contraception starting with 17- to 25-year-olds, and expanding the dental treatment scheme, notwithstanding the very real challenges. In the past two years, we have increased the budget for access to new drugs by €80 million, which is huge. That is what we have done so far to address affordability. I fully agree that we have to go further, but those measures are just those introduced this year, which is a lot to achieve in one year.

The second big focus is quality. The narrative in Ireland is that care can sometimes be hard to access, but once someone gets access to it, it is world class. We can never take that for granted, which is why we are investing so much money in clinical strategies, including the national cancer strategy, the maternity strategy, the trauma strategy, the paediatric model of care and so many more, and it is why I have focused so much and the Government has invested so much in women's healthcare. While the quality of the care and the services in most areas of our healthcare system are world class, there are areas where we have much more to do. We need a revolution in women's healthcare, which is what we are aiming to achieve.

We have to be able to access healthcare when we need it. We are doing a few things. First, we are investing in a waiting list action plan of €350 million. It is an ambitious plan. Its aim is to reduce the number of people waiting by 18% by the end of the year. If we achieve that by the end of the year, we will have the lowest waiting lists in five years. There is a long way to go and we could be derailed by Covid, but that is the plan. To date, we are on track. Some bits are going better than we thought and other bits are not going at the speed we wanted. So far, we are on track, so we will keep pushing with that. Second, we are adding permanent capacity. I will respond to some comments that we are moving slowly on permanent capacity. The facts tell a different story. In the past two years, we have added more clinicians and other staff to the HSE than in any two years since the HSE was set up. The past two years are the first and second where we have added clinicians to the workforce. We have also added five years' worth of beds in just two years. Sláintecare has a 14- or 15-year plan for capacity and investment in beds. We have done five years' worth of that in the past two years, which is important. That includes inpatient hospital beds, critical care beds, and other areas. We have added diagnostics at a level that has never been seen previously. GPs now have access to diagnostics that they never had. Some 138,000 additional scans were funded last year under a €25 million programme. This year, there have already been more than 100,000 scans, so there will be many more scans this year than last year. It is by no means sorted but there has been significant progress.

Another part of this is hospitals. We are progressing four hospitals at present, including the national maternity hospital and three elective hospitals, as well as finishing the national children's hospital. Those will make a big difference.

Finally, there is a modernisation agenda, which involves building an entire community care service. I have sanctioned 3,500 new therapists for community care. Despite the recruitment challenges, 2,000 of the 3,500 are now in place or will be deployed shortly. Some 81 or 82 of the planned 96 new primary care teams are up and running. Many of the other specialist community teams are now in place. We are deploying advanced nurse practitioners and advanced midwifery practitioners. Ireland will be a world leader in advanced practitioner practice. It will be one of the biggest changes we have seen in healthcare. We are changing the models of care so that people are cared for in their home or community rather than going into the hospitals.

It is nice to hear the acknowledgement that we are deadly serious about moving to regional health areas. We are doing so, with a serious team involved, as well as a serious advisory team led by Leo Kearns. Much work is going on there.

It sounds like the Bill will be supported with regard to both children's hospital charges and free contraception. I thank Deputies for that. I agree with colleagues that there is much more to do. Ireland is an outlier with regard to paying for GPs and some charges in hospitals. These are only two steps but they are two very important steps. For the first time, we are removing inpatient hospital charges for children. That is an important signal in respect of where we are bringing our public healthcare system. I believe the introduction of free contraception is a landmark policy change. We are starting with 17- to 25-year-olds and younger women. It is an important move. I thank colleagues for their ideas, the challenges and the support for the Bill.

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