Michael Moynihan (Cork North West, Fianna Fail)
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50. To ask the Minister for Health if he or his Department has received and read the all-party Oireachtas committee report on health that was published recently; and the way in which this will be implemented. [27561/17]

Michael Moynihan (Cork North West, Fianna Fail)
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Has the Minister for Health's Department received, read and studied the all-party Oireachtas Sláintecare report on the future of the health service, and what are his views on its implementation?

Simon Harris (Wicklow, Fine Gael)
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There was a similar question about this earlier and we will have a substantive debate, I hope, in the House tomorrow evening on the matter, but I welcome the question.

I have already spoken on this question today in response to a question from Deputy Harty, but it is important to use this opportunity again to thank and commend the committee on its work over the past year and acknowledge the thorough, open and positive approach the committee engaged in throughout this process in order to allow it to achieve this consensus report.

Regarding the Deputy's direct question, I absolutely assure him that I have read the report. Indeed, I have read it many times at this stage. I also assure the Deputy that I remain of the view that this process has provided us with a once-in-a-generation opportunity to transform our health services. People doubted that all the political parties in this House, and indeed Independent groupings, could come together and come up with a plan. With the exception of Deputy Barry, whose decision in this regard I respect, that is exactly what happened. This Government is committed to delivering real improvements in the area of health and our new Taoiseach made that very clear in one of his opening speeches last week. The report of the committee now provides us with a solid framework for delivering these improvements over the next decade.

The Deputy has rightly highlighted the issue of implementation. How we go about delivering on the report must now come to the forefront. This is acknowledged by the committee in its report when it states that "mechanisms for implementation are as important as the report's recommendations".

As the Deputy will appreciate, the report's remit is wide-ranging and its recommendations far-reaching. It is important, now that it has been published, that I give it careful and proper consideration in the context of how best we realise the vision and spirit of the report. Success will very much depend on the formulation of an effective implementation pathway. I assure Deputy Moynihan that I will move quickly on this process of consideration and following the Dáil debate that will take place in this House tomorrow I will bring proposals to Government on this very shortly.

Michael Moynihan (Cork North West, Fianna Fail)
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There are a number of aspects to the question. My experience of the health service over the past 12 months is that there is crisis in many aspects of it, but one that always evades me is home care packages and what the Government is doing about them. There is also a discrepancy in how the packages are distributed. The figures show that there are 1,200 in parts of Dublin north-west alone and only somewhere in the region of 200 in north Cork. There is a huge discrepancy in how they are distributed. The one question I have for the Minister in the limited amount of time I have is whether his Department has assessed the home care packages and if he can comment on the value for money in keeping people out of residential nursing homes and in their own homes. From the layman's point of view, it would be good value for money from the Department's point of view and the State's point of view. Has the Minister looked at these figures in real terms? Can he confirm to the House that it makes sound economic sense from the State's point of view to have many more home care packages available than there has been heretofore?

Simon Harris (Wicklow, Fine Gael)
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Yes, I can, and my new departmental colleague, the Minister of State, Deputy Daly, will have responsibility for the area of home care in so far as it relates to older people. As Deputy Moynihan will remember, we had a debate in this House recently during which his colleague, Deputy O'Dea, raised this very issue by way of a Bill. We agreed at that stage that we would go forward with trying to develop a statutory home care scheme. We all say we would like people to be able to grow old at home but the only statutory scheme available for someone who grows old and needs more support is the fair deal scheme, that is, the nursing home support scheme.

We intend to launch a public consultation process shortly to hear the views of older people on how that statutory home care scheme, an alternative to the fair deal scheme, for people in need of home help could work.

While there are many elements of the report on which we will all agree, we may not all agree on how to fund its implementation. For example, it proposes the removal of private work from public hospitals. I believe in that proposal instinctively, but it would create a €650 million hole in the health budget. Reference is made to the cost of implementing the report, but it does not outline how we would fund its implementation. The Deputy's party and mine might have a view, but the parties and groupings on the left might have a different one. We will need to tease out these issues in the coming weeks and months.

Michael Moynihan (Cork North West, Fianna Fail)
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I congratulate Deputy Jim Daly on his promotion and wish him well in the Department.

On care of the elderly, everybody is telling us that the demographics are changing and that the State needs to be ahead of the curve. When people seek additional home help hours and support within their communities, they have to dovetail with their families to ensure they can stay at home for as long as possible. By and large, when they go into a nursing home, they are fully covered under the fair deal scheme, which costs the State approximately €1,000 a week. There is still a huge challenge for everybody working with elderly people to secure half an hour or an hour of home help provision. The figures were debated recently in the House when we were told there had been no cut in the number of home help hours. The same number of hours is being provided this year as in 2015 and 2016, but the number of people who require this support has increased substantially because of demographic changes. From a constituency point of view, we find that we are constantly trying to make representations to secure additional help in order that families can work with the HSE to keep elderly people at home for much longer.

Simon Harris (Wicklow, Fine Gael)
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There will be no disagreement on this side of the House with the Deputy's analysis. The population of the country is changing; it is not just increasing. There will be 20,000 more people over the age of 65 years this year compared to last year and there will be 3,500 more over the age of 80. That trend is likely to continue into the future and will place significant demands on the health service for which we need to plan. The Deputy is correct that the home care system has largely developed with geographical inconsistencies and in anad hoc way. It is not underpinned by statute, unlike the nursing home support scheme which has a budget of almost €1 billion a year. We need to have a serious conversation about older people seeking assistance to enable them to grow old with dignity. Should we have a statutory scheme that provides people with nursing home care if that is what they require or want but which can also veer in a different way if they wish to remain in their home and have the comfort and safety of knowing that they can avail of a consistent and sustainable model of care? That is where we want to get to as a Government and where the Deputy's party also wants to get to based on what I have heard. We will shortly launch proposals for public consultation in that regard.