Jerry Buttimer (Fine Gael) | Oireachtas source

I welcome the Minister and commend him on the budgetary achievement yesterday. To be fair, it is a significant health budget. If I am honest, notwithstanding the good work of the Minister, and Ministers of State, Deputies Jim Daly and Catherine Byrne, I have never been as disillusioned about the governance of our health system. I say that as a former chairman of the health committee and as someone who sat on the HSE's southern health forum. I am disillusioned for a number of reasons. We have no accountability. The only person who is accountable is the Minister or another politician. Senator Lawlor referred to accountability and regional boards. A silo mentality is operating in our health system and, from what I can see now, there is precious little coming together. We can have all the talk we want of Sláintecare and reform, which is badly needed, but unless the patient is at the heart of our health system, we might as well take the Bill and put it up against the Sunbeam wall in Cork.

The Minister's intentions are noble and correct. We talk about good governance and accountability and to be fair to the Library and Research Service, it has produced a wonderful document for the Houses for this debate. However, I am disillusioned because I would like to know who will be accountable in the executive. We talk about transparency, accountability, participation and integrity but where are they? We have gone full circle in the wrong direction regarding the role of politicians in health. I have become a firm advocate now, having changed my mind on this, of the old health boards and the eight regions where we had politicians sitting with clinicians and other interest groups at a public forum. We should forget these meetings in Kilmainham and have public meetings with full disclosure to facilitate full openness. We are accountable as politicians. We can get voted in or out. The Minister can attend the Dáil or the health committee and be questioned. I hope we go back to that, although I know the Minister will not do so.

I welcome the fact that we are dismantling the current system. I am a firm advocate of the hospital group model and of money following the patient. I admire Senator Colm Burke's tenacity in putting down questions around recruitment and the filling of vacant positions. We are lucky to have a Minister who is committed to implementing a new model. I hate to use the word "reform" because we have had so many reports on it that it is old news. The Minister's legacy in the Department will be for people who want a health system which meets their need for access to treatment, acute hospital beds, timely outpatient appointments and emergency departments in which they do not have to wait an inordinate amount of time to be seen. Some of this is not about reform but about better management of resources. We have all been in emergency departments where people have had to wait not because of the queue but because of the process. I commend the nurses, doctors and other front-line staff in our hospitals because they do Trojan work. I was in a hospital last Sunday and saw the work they were doing.

We must go back to reality. I know the Minister wants to go so I will finish on this. I sat on the health forum when I was a member of Cork City Council.It was the greatest waste of time ever because there was no accountability or ability to get answers. It was a farce. The executive was laughing at us. We had to submit a question in advance and then we would get a written answer but - God help us - we could not go in and ask about A, B or C. I am not giving out to the Minister, and I hope he knows that, but in response to parliamentary questions, we are told the matter raised is one for the HSE and the Department cannot answer it or else we are taken from here to the Red Cow roundabout and back.