Seán Power (Kildare South, Fianna Fail)

I thank all the Senators for contributing to the debate. The Minister outlined the type of reform that is taking place and how she and the Government see our health service developing in the coming years and the investment we have made. Change does not happen overnight or without creating certain difficulties. I remember attending a conference where a speaker said that there were two certainties in life. The first is change and the second is resistance to change.

The aim of the health reform programme is to provide the best possible service in terms of quality and effectiveness to patients within the resources made available by Government and to have equity as a core value in our health service. I strongly reiterate that the importance of the health reform process is underlined by the demographic challenges facing the State; increased public expectations; the impact of medical and technological innovations; and adverse health indicators, such as the growth in obesity and alcohol consumption, as some Senators have already mentioned. All of these factors generate increasing demands on our health and personal social services.

We know that certain regional inconsistencies in service have been evident for some time, such as differences in rates of nursing home subvention and in availability of home help and disability support services. However, other less obvious inconsistencies, such as differences in admission rates and length of hospital stay, as was addressed by Senator Quinn, also must be addressed in the context of the health service reform programme. Through operating a unitary system, the HSE is now making headway in addressing these issues.

We have made considerable progress in most areas. There have been certain criticisms that we have not made as much progress as we would like in others. We are very much aware of the difficulties there and the issues that must be addressed. We have provided the funding. I know people are often critical of that, but part of solving the problem is providing the funds for it. In many cases, the attitude can be equally as important as the provision of funds.

I am convinced the health reform programme can, over time, deliver a world-class health service and significant progress is being made in the here and now with unitary health system delivery, the development of clear accountability structures and modern human resources and management systems, and the modernisation of service delivery and regulatory framework.

I will mention some areas where we have made considerable progress. In respect of structure and responsibilities, we have witnessed the restructuring of the Department of Health and Children, the Office of the Minister for Children, the HSE itself and the Health Information and Quality Authority, HIQA, which will incorporate the Social Services Inspectorate and is currently operating on an interim basis. All of these vital elements are now working together.

I mention HIQA in particular because there has been some criticism in recent times over nursing homes and the type of service that is being provided in some of them. From our experience, the majority of nursing homes try to provide quality care. By setting up HIQA and bringing in this new legislation, we will ensure that a high level of care is provided in all nursing homes and not just in some of them. It is important to note one of the core responsibilities of the Department of Health and Children is that of holding to account the HSE in regard to its financial performance and service delivery, in addition to the effects of the implementation of Government policies.

We have made major progress also in terms of financing services and strengthening accountability. Senator Feeney referred to the fact we have increased investment in the health service from €3.67 billion ten years ago to €12.95 billion in 2006. That investment has made a real and meaningful difference to the type and quality of service provided.

Senator Ulick Burke criticised home care packages. He said he was unaware of any in his area. This approach to home care was set up on a pilot scheme. A total of 1,100 packages was provided in 2005. A detailed study showed they worked exceptionally well.