David Cullinane (Sinn Fein) | Oireachtas source

I thank the Minister of State for coming to the House to take part in this debate and commend the authors of the motion on raising the issue of asthma in the Seanad. I was diagnosed with asthma a number of years ago, almost by accident. I thought I had a bad cough linked to hay fever, a condition from which I suffer badly in the summer. Most people do not realise that there is a connection between hay fever and asthma and it took me some time to figure out the link. I was prescribed antibiotics for what I believed was a cough but it subsequently transpired that I was suffering from asthma. The condition is often seasonal as I suffer most in the summer months when I also suffer from hay fever.

A staggering 470,000 people in the State are living with asthma. Even more disturbing is the statistic that one person dies from the disease every week. Some of the facts and figures presented to us are incredible. They demonstrate that asthma is a major problem on which a substantial amount of money is spent in the health service every year. It is all the more important, therefore, that the issue is discussed in the House today.

Attention must be drawn to the dangers of asthma and every effort made to put pressure on the Government, including the Minister of State, Deputy Kathleen Lynch, to take appropriate action to assist the almost 500,000 people in the State who suffer from the condition. With regard to the management of asthma, the first step of the Health Service Executive's national clinical programme for asthma should be funded. The Asthma Society of Ireland estimates that this would cost approximately €2.5 million. We often hear about the recovering economy, more fiscal space and more money about the place. Given that all Departments are facing increased demands for more expenditure, I understand the need to prioritise. However, €2.5 million, while not an insignificant sum, is not an especially large amount when set against overall State income from taxation. The Government can afford to provide the funding required to implement the first step in the national clinical programme for asthma. The issue is whether it has the political will to do so. According to the Asthma Society of Ireland, 59% of people surveyed believe asthma care would improve in Ireland if the programme were implemented. It is disappointing to note that this it remains largely unimplemented, despite being adopted in 2011. As a result of this failure, the Asthma Society of Ireland has called on the Government to set out a revised timetable and framework for its full implementation. This is a reasonable request on the part of the society.

The second step required is to introduce a free annual asthma review and written asthma action plan for all asthma sufferers. This is a common sense and reasonable proposal, although clearly the issue of costs must be considered. It is especially important given that it is reported that 59% of asthma sufferers have not had their condition reviewed in the previous years. It is also alarming to learn that 72% of respondents in a survey did not have a written asthma action plan.

A free annual asthma review is vital for good asthma management and care. Chronic disease is responsible for the bulk of the workload of hospitals and its incidence is predicted to rise. The long-term care of patients with conditions such as asthma represents a significant unnecessary cost burden on the acute hospital services where more timely and appropriate care could be provided in the primary care setting. According to the Asthma Society of Ireland's Case for Change document, asthma is estimated to cost €500 million per annum. While some measures for the management of asthma and diabetes were announced in the most recent deals with general practitioners, these are limited in scope as they allow for just two years of asthma and diabetes care and only to those already receiving a certain level of care.

A more fundamental debate about health service provision is required. On the Order of Business this morning, Senators raised the national debate on whether universal health insurance will be introduced and what type of health model or service will be in place in future.We need to reorient our health services and have a system based on need. Its central focus should be placed on prevention, health promotion and primary care. This is something on which the Government has done some good work, as should be acknowledged, as we have seen more focus on primary care centres. We now see much more value in greater investment, prevention and primary care. We must build on that in the time ahead as well.

The model of universal health care that my party is working to achieve includes GP and other primary care, as well as allied health professionals, medicines, dentistry, hospital and long-term care. It deals with many of the issues quite rightly raised by Senator Gilroy regarding cost of health care for many citizens. We end up paying anyway, whether it is through tax or private health insurance, or else people do not get the health care they need. It is a big debate for all politicians to have as to whether we want a health service that delivers the health needs of people, going beyond reactive health care to invest properly in primary health care and prevention. It costs money but we must have that debate. Are we prepared as a society to pay for proper health services? That forms part of this response as well, as it requires funding. It is easy for us in the Opposition to say the Government should do certain things, but we must be able to say we are prepared to pay for it or ask people to pay more tax for that health care. We cannot talk about universal health care or universal health insurance if we are not prepared to pay for it.

Quality of care is essential and must be at the core of the service. Outside of waiting lists for specialists, perhaps nowhere is access to health services more unequal than in primary care. In primary care, entitlements are given or denied on the basis of household finances or employment status rather than medical need. I commend the authors of the motion. It does not just mention the problem as it also puts forward solutions. It calls on the Government to do a number of things, some of which I referenced. The Government should consider the recommendations being made by the authors of the motion, as they have done their research, as well as the advocate organisations. We all want the recommendations to be implemented.