Liam Fitzgerald (Fianna Fail)

I welcome the Minister of State to the House. I also welcome this ambitious and challenging reform programme which he, with the Minister for Health and Children, Deputy Martin, and the Department have set before us.

It represents a huge challenge to address serious ongoing problems in the health service despite the phenomenal investment in recent years. Some commentators such as Colm Rapple have estimated that there was probably more investment in net additional terms in the health service than in all the other sectors put together. I am not sure he is correct, but it is a statistic he put forward two or three years ago in the media. Either way, the extent of the increased investment in the health service is quite spectacular. One quarter of entire public expenditure is accounted for by health – in excess of €9 billion, which is almost the entire income tax take. It is frightening that such quantities of money are invested in a service, which by its nature is extremely wide ranging and touches every community. It will also continue to expand, given the demographic changes that have taken place. The challenges facing the Minister and the Department will be correspondingly greater.

Looking into the future I am reminded of the words of the poet, Brendan Kenneally:

Though we live in a world that thinks of ending

that always seems about to give in

something that will not acknowledge conclusion

insists that we forever begin.