Ivana Bacik (Independent) | Oireachtas source

Both Government parties had manifestos based on radical reform. The programme continues, "This Government" is committed to introducing "Universal Health Insurance with equal access to care for all." The programme acknowledges, as do Ministers, that reform will not be easy and will be a difficult process that will take a little time. It is a process that is well worth carrying out and has already started. It is due to the radical reform that we have seen reform in primary care. That is the first step. Following the commitment to universal health insurance given in the programme for Government, there is a commitment to introduce universal primary care. That is a radical new proposal that will be brought in through an ambitious four-phase programme that will ultimately result in free access to GP care.

An integral part of primary care reform is the idea that a stimulus package would be provided and the Minister referred to it in his speech. Such a package would include - and it was announced as part of the infrastructure stimulus package announced by the Minister for Public Expenditure and Reform, Deputy Howlin on 17 July - projects to meet key infrastructure needs in line with priorities identified in the investment framework, including primary care centres. Some Opposition Senators have been critical of the idea of building new primary care centres but I disagree with them. It is our strong policy to have new primary care centres. I have had direct experience of them in other countries such as Spain which has an excellent primary care network. They have a one-stop-shop in local communities with access to GPs, dental treatments and a range of treatments that most Irish people must go to hospitals to access. A move towards primary care centres is progressive. The building of centres is also part of a job creation stimulus package.

I am delighted that the Minister of State, Deputy White, will drive forward the reforms. Clearly, there have been frustrations caused by delays in rolling out the four-phase programme for primary care. Steps have been taken. It is important that we push the programme forward and see it as part of the overall package of health reforms.

I pay tribute to the former Minister of State, Deputy Shortall, and thank her for her pioneering work in primary care. She also pushed forward a very important health measure for dealing with alcohol abuse. I know that her replacement, Deputy While, will progress her work.

The Seanad Public Consultation Committee recently held good hearings with NGOs and groups working on preventive health strategies, particularly cancer prevention. I look forward to sharing the findings of the public consultation committee with the Minister of State and the Department of Health. Health strategies are an important part of a health care system. It is also about cost saving and ensuring that people have access to health care at the earliest possible opportunity.

All of these radical reforms would be difficult in the best of times but they are particularly difficult in the current economic climate. The Government's amendment makes reference to that. It points out that the Minister for Health has managed an impressive cost reduction in difficult times, that waiting lists have reduced, and we have all heard the figures, and that the Croke Park agreement has delivered real results in the health care sector. Health service staff reductions amount to over 6,000 people yet we see efficiencies are being delivered. It shows the achievements that can be gained with greater efficiency through the Croke Park agreement.

It is also clear that the Minister inherited problems such as budgetary strategy and financial management in the Department of Health. We are changing that through new changes to HSE governance.

We have inherited the HSE, a creation of the previous Government. It is important to ring fence budgets in the way we ring-fenced the mental health budget under the Minister of State, Deputy Kathleen Lynch. In primary health care the programme for Government provides for ring-fencing for additional psychologists, counsellors and community mental health teams.

I was delighted to hear Senator Crown voice his support for the amendment and for the Government's reforms. We need to keep in our sight the very radical nature of the reform being introduced and the vast amount of work it will take as well as the critical goal we all share of access to health care on the basis of need rather than on means.