Rose Conway Walsh (Sinn Fein) | Oireachtas source

I may not use the six minutes. I thank the Minister for attending. I will be really positive. I thank the Government for its investment in Áras Deirbhle nursing home in Belmullet because for many years there was no investment in that nursing home. This is hugely important in the context of what I am going to say.

In light of the negative impact on rural areas of centralising and privatising health care in Ireland, Britain and many other countries, will the Minister consider a proposal to provide as many health services as possible in rural and urban settings where the larger hospitals are situated many miles from acute specialist hospitals? Sinn Féin and I have long believed that a new approach is necessary to overcome the challenges met by people living away from these centres in accessing health care. This growing problem is not confined to remote rural areas, although the lack of transport, the absence of a good road network and the cost involved in accessing the most basic services is greater in these areas, including the place where I live in Erris, County Mayo.

There is a really good strategy, Developing Community Hospitals, is use in Scotland, so there is no need for us to reinvent the wheel. The Minister may be familiar with Belmullet hospital and the fact that, under the then Fianna Fáil Government, half of the beds there were closed in 2010. We led a very active campaign, Senator Mulherin with testify to this, to try to keep those beds open. However, the then Government insisted on closing them. We are left with an infrastructure of quite a large hospital that could be used as a centre for the delivery of the services we need. Will the Minister consider a pilot project to develop a multidisciplinary health service facility at the hospital in Belmullet and have a cost-benefit analysis carried out in order to deliver this? We could lead the way in terms of examining whether this might be a method of tackling the shortfall in the provision of services between the centres of excellence and the acute centres. We could look at the possibility of a community casualty unit to prevent people having to travel elsewhere to have minor injuries treated. We could examine the development of electronic health records in order that people's patient information could be available, provided proper broadband services were available. We could also revisit the whole development in technology which never happened but which was promised under the Primary Care strategy. The Minister will recall the pilot projects established in the context of Primary Care. The major problem with those projects was that proper resources were never provided in respect of them. Putting a sign saying "Primary Care" above a door does not make a facility a primary care centre. Investment is needed. The electronic potential identified within those centres could now be used not only for primary care but also in the development of these multidisciplinary health service facilities. We could test this model in Belmullet in order to discover if it will work. Many safe and effective services could be delivered at local level using this model. We could have an integrated patient transport policy included in these hospitals. My direct question to the Minister is whether he would be willing to look at it and whether he would be willing to work with us in the community of Erris in Belmullet to test this model in order to establish whether it would work in other areas of the country also.

Mr. Simon Stevens, head of the NHS in England, realises there are many shortcomings in the centralisation and privatisation of health services. The way in which our health system has developed has left us in a situation with which none of us agree whereby one's treatment is based on where one lives. Whether a person lives or dies can come down to where he or she lives. People in areas such as that in which I live are at a major disadvantage in trying to access services. I remind the Minister that patients from Belmullet seeking to access the most basic services currently being delivered in Galway are obliged to make a six-hour round trip. Some people may have two, three or four appointments in one week. That is not the way to treat some of our most vulnerable people, namely, those who are ill and who require to access health services.

I ask the Minister to examine the Cuban model of delivery, which is very interesting. Even in terms of cost, it delivers an excellent health care service to a population of 11 million for less than it costs to deliver the services at Beaumont Hospital.

Will the Minister to comment on the ESRI report on the possibility of the delivery of universal health care, particularly as that has long been our policy? Universal health care has often been ridiculed on the basis of the argument to the effect that we cannot afford it. We have always said we could afford it and it is interesting to have the evidence to back that up.

I look forward to working with the Minister and I hope he will have an open-door policy in terms of addressing all of the issues to which I refer. I ask him to consider the impact on the health service of the policies of previous Governments and how that has militated against people living in rural Ireland in particular.