Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

Concerning individual queries, I am sure these are very difficult cases and if Deputies want to pass on the details to my office or the relevant Minister, we will try to provide a reply. It is not possible in this forum to respond to individual cases because there is always much more to it than can be put across in a minute or two by a Deputy and we need to know all the facts.

Regarding the Sláintecare programme, our programme to bring about universal healthcare, it has three principles: affordable healthcare for everyone, good patient outcomes and timely access. We are making a lot of progress around making healthcare more affordable, of which I mentioned some examples in my reply earlier. Patient outcomes in Ireland are good and much better than in the NHS, for example, which is often used as a model to follow.

It definitely is not. Where we are not doing well is on timely access. That is where we need to make much more progress in the next year or so.

Sláintecare has the support and oversight of the Department of the Taoiseach. That is being enhanced currently. When it comes to the Sláintecare programme, there is now a report to me every two months, as chairman of the Cabinet committee on health. One of my advisors and one of my officials now sit on the Sláintecare delivery board.

With regard to community care, which was raised by Deputies, we are working very closely with the Minister of State, Deputy Butler. The problem we would have had five or ten years ago was that we had the staff, but not the money. It is now the reverse: we have the money, but not the staff, in large part due to full employment. We are working on means to increase the number of people we can get working in home care and community services and that includes increased pay and terms and conditions; payment of the living wage; payment of people during travelling time, as they travel from client to client, and 1,000 new work permits to bring care staff into the State.

I do not have any information on Macroom, but I will take it up with the Deputy and come back to him with a reply, once I have one.

From talking to professionals in the area, in particular, the assessment of need process has become a real difficulty. When the right to an assessment of need was introduced by the Oireachtas, it was done for all the right reasons, but it has now become a barrier, because children cannot get the therapies they need until they have had their assessment of need completed. I am told a full assessment of need takes 20 or 30 hours. It has become a barrier. An abridged system was brought in, that would do shorter or rolling assessments of needs, which meant children were getting the therapies much quicker and waiting lists were coming down, but the court struck that down and said that everyone has to have a full assessment of need. It has created an enormous problem, unfortunately. We need to look at that and revisit it to see how best we can sort it out. It should not be the case that someone who clearly needs speech and language therapy, and a one-hour assessment can determine that, cannot get it until they have gone through a 20- or 30-hour full assessment. It is an example of how rights-based legislation can backfire. An honest attempt to give people a right has now put us in a situation where that right has become a barrier to the treatment they need.

With regard to the 900,000 people on hospital waiting lists, that is true, but it is not the full truth. Many of those people are waiting a few weeks; maybe six or ten weeks. It also includes people awaiting annual checks. One can wait up to a year for an annual check, in fact one has to wait at least a year for an annual check. It includes duplicates, people who have been treated already and people who are suspended from waiting lists for various reasons. In the Sláintecare programme, we agreed good criteria around waiting lists, whereby nobody should have to wait more than ten weeks to see a specialist and no more than 12 weeks for a procedure that they need. When one uses that figure, there are approximately 450,000 people waiting longer than they should have to, but that figure has come down. It was lower at the end of last year than it was the year before. Very few jurisdictions have seen their waiting times go down. Ours have and we have a target to bring them down further this year. It is great to see some progress on it. They are far too high and too long, but we are one of the very few countries that is seeing its waiting times fall, that is, waiting times at end-2022, versus end-2021. They will fall again this year. We are doing it both through expanding capacity and by using the National Treatment Purchase Fund, NTPF, as a source of additional capacity.

Everyone knows that recruitment in the health service is an enormous challenge. We have full employment. We have enormous international competition. Canada, America, Australia and New Zealand are short too. That is why they are bringing in staff from abroad, including from Ireland. The housing crisis does not help, but we should put into a factual context that since this Government came to office, we have hired an extra 7,000 nurses, midwives, doctors and dentists. We have never had more GPs with HSE contracts. We have never had more nurses or consultants working in our public health service. That is, of course, against a backdrop of a rising population and increasing medical need, but we should not give in to this false narrative which would have people believe that we have fewer nurses and doctors, because they are all leaving. The facts are otherwise. There are people coming and going and, in the round, we have never had more staff in our health service and the numbers are increasing every day. We will hire an extra 6,000 this year.

I met with the new HSE CEO for the first time yesterday. We discussed reimbursements. The Deputy was on my mind at the time. He said to me that only in the past couple of weeks, a considerable number of additional medicines have been approved, that is, new molecules and indications. However, we agreed we would make it a specific item for discussion at the next sub-committee meeting or the one after, because we acknowledge we need to speed up the reimbursement process for medicines in Ireland. One thing that was said back to me and I think it is a fair point is that we always hear about the ones that are approved abroad, but not in Ireland. We rarely hear about the ones that are approved in Ireland and not abroad. That was a fair point.

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