Seanad debates

Tuesday, 4 November 2014

6:35 pm

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael) | Oireachtas source

It is certainly Sinn Féin policy to transfer €90 million in costs to private health insurers which would essentially drive more people out of private health insurance, increase the demands on the public system and make the two-tier system even worse. That is very much Sinn Féin policy.

The health service is very difficult to reform and change. If it was like a ship, one could close it down, put it into dry dock and fix it but one cannot do that with the health service. One must rebuild the ship while it is still sailing. As we deliver reforms in the health service we need to make sure that we can keep the show running at the same time. That is what makes reforms very tricky. Like a lot of things in Ireland, we would not set it up the way it is currently were we starting from scratch now. However, we have the health service that we have now and we need to reform it in ways that do not make it worse. Unfortunately, some reforms have done exactly that.

The graduate nursing programme which also came up in the discussion is currently under-subscribed. I had hoped, in consultation with the nursing unions, to make it more attractive for nurses. It is proposed to offer nurses on the graduate nursing programme temporary contracts to work as nurses within the system.

There was a comment on Positive Action but I do not want to get into that too much because the matter has been referred to the Garda Síochána. However, I do not believe there is anything sinister in the timing of the release of information and believe it was entirely coincidental. I have no reason to believe otherwise.

Senator Crown mentioned muscular dystrophy and Friedreich's ataxia. I cannot imagine a reformed system which would refuse a medical card to someone suffering from either condition unless that individual was at a very early stage of diagnosis or had a very high income. When the expert group grappled with this issue, it was not the barn-door cases with which they had a problem but those in the middle. That is where it gets very difficult - deciding where to draw the line. That said, any set of clinical guidelines that takes cognisance or account of medical hardship and the burden of disease will not struggle to make the right decision when it comes to something like muscular dystrophy or Friedreich's ataxia. We will have to wait and see how the revised system works and potentially refine it as we go along.

Senator O'Brien had a lot of questions about the new children's hospital and in that context, Senator Crown made a very valid point. We are never going to have 100% consensus on the site and are always going to find members of the public, doctors and other interest groups who do not agree with the decision, no matter what that decision is. What we have now, at long last, is broad acceptance of the St. James' campus among political parties, the three existing hospitals in Dublin - all of which want to move as soon as possible - the universities, the staff of the hospitals, most of the unions, the parents' groups and the National Children's Advisory Council. Even groups that are ambivalent about the site are very keen to ensure that there will not be an additional set of delays. Such delays would be inevitable if the decision on the site was revisited. A lot of the questions posed were very detailed and would be better directed to the development board of the hospital. I will ask that the board provide answers to the Senator's questions. Obviously any of the planning and logistical issues will have to be considered by An Bord Pleanála in a few months' time. Part of the planning application will require the submission of a master plan.

I am uncomfortable talking about individual cases in public or in Parliament. As parliamentarians, we should consider whether we want to raise individual cases in the Houses. That said, I understand that with regard to the four individual cases mentioned by the Senator, a debate is being taken by the Minister of State at the Department of Health, Deputy Lynch, in the Dáil later today. I did not have time to look at it myself because I have three debates to take in this House today. The Minister of State will take that debate later and I know that she is also examining the suicide prevention strategy.

Administrative staff were also mentioned during the debate and both administrative and managerial staff in the HSE get beaten up very badly, in a verbal sense. If one looks at the figures, however, the number of administrative and managerial-grade staff in the HSE is actually at its lowest since the executive was established while the number of doctors and dentists working in the HSE is actually at its highest ever level.

If one spent too much time getting information from the media one really would not think that. Instead, one would think that there was a massive explosion in administrative staff with fewer doctors than before but that is not the case. We have fewer nurses than before but that is a separate issue.

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