Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Senators for their contributions. There were many similarities in the themes being raised, many of which I can relate to and support. I will try to respond to a couple of them. The very issue Senator Buttimer outlined in raising the challenges public representatives feel - this is not about public representatives - on behalf of citizens is one of the reasons we need to reform the health service. I, too, chaired a regional health forum before I was a Member of the Oireachtas. I do not mean to be in any way disrespectful to the councillors up and down the country who go to these forums and do fine work, but they do not have enough powers or teeth to get the answers they want on behalf of their constituents. We will set up regional entities which will have boards. I will consider how public representatives can have an input and play a role in that regard.

I do not mean to be disrespectful to any colleagues here or in the other House, but it is bizarre that, in a national parliament, the Minister for Health can be before an Oireachtas committee or in the Dáil or Seanad answering questions on very local issues. I do not mean that rudely or disrespectfully. I am happy to answer questions all day long and I know the reason Members find they have to raise these issues in the Houses is that they often cannot get an answer at a local or regional level. When such issues have to be raised here it is a sign that something somewhere else in the chain is not working well. We have a chance now, as we develop these new structures, to get the governance right at a national level. We need a national entity. While we can do a great deal in the regions, we would not have delivered a national cancer strategy, a national maternity strategy or many other things if we did not have a national entity. A national health service is needed, but we also need to be able to devolve more functions, as appropriate, to the regions in what is a relatively small country. For this reason, we intend setting up integrated regional entities in order that the silos can be broken down and we can avoid a scenario whereby community health has a budget and management structure in one location, the hospital group has a budget and management structure in another and the two never meet.

The good news is that this is not just my view but one to which every political party and grouping in both Houses of the Oireachtas has signed up through the Sláintecare plan. Sláintecare is a ten-year plan, which we will not be able to implement overnight. That is not what we need to do in health. What we need to do is to keep working away at a vision regardless of who the Minister is or who is in government because we have all signed up to the same policy direction in a bipartisan fashion.

Yesterday was a very important day for Sláintecare because we now have more than €200 million to start making the plan a reality. We have a €20 million integration fund and, on the capital side, €6.6 billion of health capital funding will be directed towards Sláintecare over the next ten years. We reduced prescription charges and the threshold for the drug payments scheme and we provided for more people to access free GP care, all of which were Sláintecare recommendations. Today - probably as I speak - representatives of a doctors' organisation are in my Department seeking to recommence talks on a GP contract in order that we can make general practice sustainable, something which I know is very close and dear to Senator Keith Swanick's heart and which he raises and advocates for in this House.

We have the policy and resources but we need to have the proper structures, as all of the Senators have said, to make sure that those resources and policies get to where we all want them to get to. We want staff on the front line and patients - citizens - using our health service. It is clear to me that the distance, as Senator Colm Burke eloquently alluded to, between the decision-making process and the citizen is often far too big. We need to look at how we can address that.

I will now answer a couple of specific questions. In respect of how people are selected for the board, we will use the Public Appointments Service. I issued a statement today noting that this process is under way. We also selected the chair-designate of the board through that process. The chair-designate is available to go before the Oireachtas Joint Committee on Health. I am sure he would welcome that. I would welcome the chance for the Oireachtas Joint Committee on Health to meet him as well. Senator Lawlor made a number of interesting points on how we could improve the legislation, as did Senator Devine and others.