Joe Higgins (Dublin West, Socialist Party)
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1. To ask the Taoiseach when the Cabinet committee on health last met. [26765/14]

Joe Higgins (Dublin West, Socialist Party)
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2. To ask the Taoiseach when the last meeting of the Cabinet committee on health was last held and for when is the next one scheduled. [35181/14]

Micheál Martin (Cork South Central, Fianna Fail)
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3. To ask the Taoiseach if the Cabinet committee on health met recently. [35594/14]

Micheál Martin (Cork South Central, Fianna Fail)
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4. To ask the Taoiseach the number of times the Cabinet committee on health has met since 2011. [35601/14]

Enda Kenny (Mayo, Fine Gael)
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I propose to take Questions Nos. 1 to 4, inclusive, together.

The Cabinet committee on health last met on 29 September and the next meeting is scheduled for early November. The committee has met on 27 occasions since this Government came into office in 2011.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Taoiseach for his reply. The frequency with which the Cabinet committee on health meets is instructive in itself. For three and a half years, every time the Taoiseach was asked a question in this Chamber about the health service, he replied that everything was going fine and getting better. Waiting lists were disappearing, treatment was getting better and reforms were on the way that would cure all our problems. The work of the Cabinet committee on health, we were told, was all about the health reform programme. In the midst of all this, we had the Taoiseach's consistent denial of there being any attempt to take medical cards away from families. Eventually, after months and months of our pursuing that issue, he had to change tack, admit he had made a fundamental error and reinstate discretionary medical cards to many needy families across the country. We now have new evidence that waiting lists have been falsified. Not only was the budget last year falsified, but we discover the waiting lists were rigged to give a better picture. This all happened since the then Minister, Deputy James Reilly, abolished the independent HSE board without putting anything in its place, which was a big mistake.

The Taoiseach indicated that the next meeting of the Cabinet committee on health, chaired by him, will be in early November. The Minister, Deputy Leo Varadkar, and his officials are saying that the health reform proposals initiated under the previous Minister are not workable or implementable and will be pushed out to 2023 or some other date in the next decade. That shows some amount of arrogance. Do we need more frequent meetings of the Cabinet health committee to get a grip on the situation? One has to wonder what that committee has been doing for the past three and a half years. The Taoiseach chaired the meetings at which the publication of the White Paper and the reform documents were approved.

Now all that spin has been exposed as empty rhetoric as opposed to having any substance because the Minister and others have said this cannot be implemented and the reforms are not workable. Does the Taoiseach need more meetings of the Cabinet sub-committee to get a grip on health?

Enda Kenny (Mayo, Fine Gael)
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No, actually. As I said to the Deputy before, I devote one Monday in the month to Cabinet sub-committee meetings and, occasionally, if people are not available or whatever, we have them on a different day. I find it is better that way. One has timelines and issues that need to be dealt with.

No one doubts the scale of the challenge facing any Minister for Health. I recall the Deputy declaring the abolition of waiting lists entirely many years ago, but this never happened. Who knows what demands lie ahead from winter vomiting bugs to viruses to other things that come this way. The new Minister for Health, Deputy Varadkar, has a number of new personnel in his Department and in the HSE looking at the scale of what he faces. For instance, we recognise that in the longer term, the move towards universal health insurance will be a way to end a discriminatory and unfair system and bring about a situation where people have treatment based on their needs, which will reduce costs overall. The Minister is working hard on the development of that policy and on the determination of the range of costs.

Micheál Martin (Cork South Central, Fianna Fail)
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He said he was not.

Enda Kenny (Mayo, Fine Gael)
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He is.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I am afraid we are straying a bit from the original question.

Enda Kenny (Mayo, Fine Gael)
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The issue of waiting lists, to which the Deputy referred, has been in the news in recent days. I have heard authoritative sources from the HSE address this question. The manipulation of waiting lists has been denied both by the Minister and the HSE and they are very clear on that. The Deputy knows there is a €500 million overrun in the HSE and the Department of Health this year, so we have to start from 2015 and the budget next week and see the most practical and feasible arrangements that can be put in place to contain costs while maintaining front-line service delivery.

In regard to the row we had about the medical cards, obviously, there was some very-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I apologise for interrupting the Taoiseach but we are straying way beyond this question. You were asked a simple question on when the Cabinet sub-committee last met.

Enda Kenny (Mayo, Fine Gael)
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I answered that. To clarify, people who lost their medical cards under the discretionary system and had them restored need not worry. They will continue for as long as necessary.

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach said this particular sub-committee has met 27 times. The issue of health is one that affects every single family and probably one of the most important issues for people is to have the comfort of a health service which is fit for purpose. I accept what the Taoiseach said that it is a major challenge to try to straighten out the existing mess but the number of meetings falls far short of what is required because in the period of this Government, we have had a change of Ministers and the new Minister has set aside many of the timeframes, schedules and some of the commitments of the Government's programme of reform for the health service.

The number of people waiting on trolleys has gone up and down in Our Lady of Lourdes Hospital in my constituency as well as in other places. I also know many people have not had their medical cards restored. My constituency office is inundated with people who do not understand the outworking of the review, and I am sure it is the same elsewhere.

I have often pondered on the Taoiseach's role in trying to chair all these sub-committees and getting the business and mechanisms of Government joined up - not one of his strong points - cohesively and in a co-ordinated way. The number of meetings falls far short of what is required by this important sub-committee, given the challenges facing the health portfolio.

We are restricted because we cannot ask what is discussed at the meetings, which is a bit silly. It is not the Ceann Comhairle's fault. Is the Taoiseach confident that the amount of time this Cabinet sub-committee devotes to the issues placed on its clár, whatever they may be, reflects the importance of the issues and the great priority and concern many people have about our health services, the welfare of ill members of their family, the elderly and the people with disabilities?

Enda Kenny (Mayo, Fine Gael)
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The Cabinet sub-committee deals with a range of issues about health, whether general expenditure, the HSE implementation plan, the development of concepts such as money follows the patient, strong primary care and community systems, the hospital groups and their development to a point where they will make recommendations in due course about services and how best they can be provided, the complicated procedure that followed the announcement of the development of the national children's hospital, the Central Mental Hospital and the National Maternity Hospital going to St. Vincent's University Hospital, the development of primary care centres, of which there is one per month, the constant challenge of reducing agency costs for nursing, and the challenge arising from the Haddington Road agreement and general pay agreements. These are all issues plus other relevant features of the health system, including Healthy Ireland, the change in the nature of treatment of many issues, the development of new drugs, and dealing with drugs companies and costs. These are all part of the work of what is truly a massive organisation, between the Department of Health and the HSE and all those who work for it. They are the areas at which the Cabinet sub-committee on health looks.

For instance, the concept of the development of universal health insurance from beginning right through to fruition is something that may take well into the second term of government before it is realisable. One must have the money following the patient, a strong primary care and community system and the hospital groupings all in place before that can happen. There are issues of insurance, costs and private health insurance and the necessity to have more people understand that they can enter this system much earlier than heretofore, thereby helping everyone.

Of all the Departments of Government, Health is one that affects every single person in one way or another and every single household. The Minister's challenge is to stabilise the health system in order that it can deliver the results we expect at the front line while at the same time manage it to a point where the evolution of universal health insurance, the development of the hospital groups and the provision of services throughout the country are in the best interests of the patient. The patient must be central to this.

It is not an easy issue to deal with in terms of contracts, renewal of contracts, the GP services for those under six and for those over 70. These are all elements of work which the Minister is overseeing. As a Minister who is new to that Department, he must have time to get a grasp of the priority issues with which he has to deal while at the same time seeing how costs can be contained in a massive Department where the situation is demand led and where it is impossible to determine what the scale of demand might be as it depends on the issue that might arise in any part of the country.