Kate Walsh (Progressive Democrats)

I welcome the Minister of State, Deputy Power, to the House. It is an honour to speak in his presence. I am delighted to have an opportunity to speak on this important Bill.

The two key requirements of the health service are investment and reform. On the investment front, over the coming year the Government will invest €11 billion in the health service. That is by any standard a huge amount of money. It is an increase of €1 billion on the amount spent in 2004 and accounts for 25% of all expenditure on public services, yet we still have people waiting on trolleys and overcrowding in accident and emergency departments. That is the reason the reform programme is as important as the amount of money spent.

The current health system has been in existence for over 30 years and is creaking under the strain. Its inability to cope is best demonstrated by the absence of an improvement in service or output, despite the significant increases in investment the service has received. Reform brings many challenges, and the Minister, Deputy Harney, is rising to them. Ten weeks after taking office she has introduced a Bill which will radically overhaul the way our health system is managed and is determined it be passed by both Houses of the Oireachtas before Christmas. I and my party colleagues will do everything to support her endeavours. The Opposition claims this Bill is being rushed through too quickly. Ironically, the same Opposition has been demanding reform and action for the past 12 months. Confronted with ambitious and significant legislation, it now balks at the opportunity.

I congratulate the Minister and her Ministers of State on grasping the nettle of reform and embarking on this programme with courage, commitment and conviction. The Minister has a track record of confronting and succeeding in challenges, such as smoky coal in Dublin, ending the nightmare of emigration and dole queues and the insurance industry. She will also succeed in this challenge.

When the Estimates were announced on November 18, the Minister made it clear her tenure at the Department of Health and Children would not be more of the same. With regard to the issue of medical cards, she was faced with a stark choice to either simply extend the number of traditional medical cards by 45,000 or choose a more innovative approach. She chose the latter. The new GP cards will enable an additional 200,000 people to visit their GP free of charge. This will relieve pressure on accident and emergency units as many people go directly to A&E because of the cost associated with visiting GPs. These new GP cards will allow thousands of families visit their doctor and receive assurance at no cost. The 30,000 additional medical cards and 200,000 new GP cards constitute a great initiative and the Minister deserves congratulations.

This legislation will have a very significant effect on our health service and consolidate its fragmented structures. We are all too aware of the failings of the current system. It is a towering bureaucracy which successive Ministers of Health have tried in vain to contain. To an extent, the Bill represents the enactment of copious reports recently commissioned by the Department of Health and Children. It is time that such reports, commissioned at substantial cost, are implemented and this is what the Bill seeks to achieve.

The Health Service Executive will reform and restructure the way in which health services are delivered. In its role as a separate entity it will be able to call on the expertise of various people needed to achieve success. It can interact with the Department in a unitary way and demand the Department sets clearly identifiable goals and policies. There will no representation in the north west and or south east. It is time we got away from that so that we know what we are doing.

The case for reform of the health service is compelling. We need a service that is responsive and appropriate to the needs of the 21st century, that puts the patient first and is accessible to all. If the structures and functions of the current system are not organised or capable of delivering the ambitions of the health strategy, now is the time for change.