Jerry Buttimer (Fine Gael) | Oireachtas source

I do not want to begin on a discordant note. In the spirit of the motion and the amendment, the fundamental point is that if we are spending money in the health service we must have accountability in how that money is spent. It is not the case that we have a pot of gold, as Sinn Féin has discovered in the North of our country where it has had to make tough decisions in government relating to the health system.

I have huge respect for Deputy Ó Caoláin, with whom I worked in the previous Oireachtas Joint Committee on Health. However, other Sinn Féin Deputies seem to want to be populist and promise all things to all people. If we are to have a cross-party collaborative approach to health, let us have it in real time and real terms. We do not have enough money to spend on everything and we need to recognise that the most important thing we can do as a country is to have people at work who can make a contribution so that we can have money to pay for services while at the same time respecting that those who need our help and assistance should have that from the State.

We all begin from the premise that the waiting times are unacceptably long. The most important point is that this is about expediting access to surgery and treatment. Those of us who are living in the real world have people coming to us every day of the week looking for hospital appointments fast-tracked or to be taken off a trolley.

We need the whole of the Oireachtas to stand firm in bringing reform, including the HSE's lack of accountability because there is no person who will take the flak for the waiting times or for the cancellation of appointments. Senator Colm Burke has been beating this drum for a long time. While I accept there have been a multiplicity of reasons, 487,519 appointments have been cancelled. What does that do to the system? Trying to bring reform through the future ten-year strategy or whatever requires us to stand up to vested interests. I say to Senator Gavan that means standing up to the unions. I say to Senator Swanick that means standing up to the GPs and consultants. We all need to ask how we can make it better for the patient, who is at the centre of what we should be doing, as opposed to pursuing vested interests.

The amendment to the motion indicates what Fine Gael is trying to do in government. We must change work practices relating to diagnostics. It is crazy that a person cannot get an X-ray on a Sunday. I know of a patient who has been in hospital since the second week of January because his consultant is not available to carry out an operation and he cannot leave the hospital bed because if he does, the operation will be cancelled. That is the height of daftness; it makes no sense. I can get an operation in a private hospital at 9 p.m., but in some cases we cannot do that in public hospitals. Where we find commonality is in how we can change work practices, as Senator Reilly said.

I believe the model of the money following the patient is very good because it delivers to hospitals that perform and treat patients as patients, and get benefit from it. We need to revisit the special delivery unit model, because it delivered at a time when we did not have money in our health system. It went down to the coalface and had an impact. It engaged with clinicians and analysed what could be done, and delivered.

Irrespective of our ideology, we all agree that we need more beds, be they in Limerick, Cork, Galway or Mayo. Senator Colm Burke pointed out that the last new hospital built was in 1998. If we went into our communities and said that there was no new school built since 1998 we would be frogmarched to every public meeting and told it was unacceptable. I fully endorse what Senator Colm Burke has been saying, namely, we need new hospitals. This could be done through public private partnerships. We can approach the European Investment Bank proposing a model that can deliver patient care, cutting waiting lists and getting people inside hospitals. I accept that is a quantum leap for some.

I have made that journey because I have the experience of teaching in a public private partnership school. Let me tell Members who have a difficulty with that, the school is still there. There is no denigration of service. There is still community access. The building is pristine and the school is operational. Why can we not do the same with our hospitals? We do it with our roads and pay a toll. Today someone travelling from Cork to Dublin will pay a toll; we could use public private partnerships to deliver hospitals buildings.