Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank Members for the opportunity to meet with them this evening. We are here to discuss what I believe is one of the most important projects of our time, which is to make universal healthcare a reality in our country and to have a public healthcare system that provides girls and boys, women and men, with great healthcare when they need it. We allocate a great deal of money to healthcare. We have incredible healthcare workers doing extraordinary work every day. We have wide political agreement that universal healthcare must happen, but let us be honest, there is a long way to travel. Even with the intense pressures Covid-19 brings, our healthcare workers are keeping critical health services going and they deserve immense credit for that, but many children and adults are waiting far too long to see a consultant or to get a scan or to have a procedure. In one of the wealthiest countries on earth, this is completely unacceptable. As I have said in the Dáil and as I have said at the Joint Committee on Health, the Government and myself are absolutely committed to the goal of universal healthcare in our country.

This year has already seen a very significant investment of more than €1.2 billion in new initiatives. We are on track, or on track with minor issues, on more than 97% of the projects tracked under the Sláintecare implementation strategy.Increased investment in the health service has allowed us to increase capacity, which is fundamental to improving access to care. Hospital bed capacity has increased significantly. Approximately 850 permanent beds have been added to the hospital system this year and more will be added by the end of the year. This is the single greatest increase in hospital beds in any one year. Some €52 million was provided this year to increase critical care capacity and we have delivered a record increase in critical care beds from 255 to a planned 321 by the end of the year, or very early next year. This represents an increase of more than 25% in our national critical care capacity in less than two years. There are 6,000 more staff working in the health service than there were last summer, including almost 1,400 more nurses and midwives and 1,200 health and social care professionals. These staff were hired at the same time that we hired thousands of other professionals to help us with testing and tracing and rolling out the vaccine programme.

Various initiatives and reforms are ensuring that people are receiving care closer to home. A total of €25 million was allocated to our GP access to diagnostics initiative this year. It allows GPs in a community-based setting to refer patients directly for diagnostic scans, such as X-rays and MRIs. I am delighted to inform the House that an estimated 140,000 additional scans will be carried out by the end of the year as a result of this programme.

Waiting lists for funding approvals for home care have seen a real reduction, thanks to a large increase in funding. This is delivering on the objective to keep people well at home and out of hospital or have them discharged from hospital as quickly as possible.

Prevention is an important component of modern healthcare. I am looking forward to launching the new healthy communities programme in Darndale tomorrow, which aims to improve the long-term health and well-being of people living in 19 communities across the country.

All the progress we have made has been achieved while dealing with the worst public health crisis in the history of the State. We now want to build on the investment and progress made so far this year. I am delighted that budget 2022 reiterates and reinforces the commitment to universal healthcare. The allocation of €22.4 billion, the largest ever investment in Ireland's health and social care services, will reduce waiting lists, increase capacity, protect our most vulnerable, address inequalities and deliver the right care in the right place and at the right time.

Tackling waiting lists is my number one priority. Waiting times were unacceptable before the Covid crisis and have worsened since. Many people right across the country are living in pain, some of them in agony. The long waits that many people face to access care are causing immense distress. My Department, the HSE and the National Treatment Purchase Fund, NTPF, are finalising a multi-annual plan that will set out a twin-track approach of investment and reform. It will be overseen by a ministerial task force, following the vaccine task force model that has worked so well, and will include a number of short, medium and long-term actions. The short-term actions are already being implemented as part of the short-term waiting lists plan for this year. Next year, we have allocated €350 million to this approach to tackling waiting lists. Addressing waiting times will also require significant investment in elective care. A proposal for three elective hospitals, which will focus on planned care, has been completed and is being evaluated by my Department.

Universal healthcare must mean higher quality healthcare. There is a lot of focus, very understandably, on access. The general narrative is that sometimes it can be very hard to access our public system but, when one does, the care is excellent. In the vast majority of cases, that is certainly correct. We must continue to invest in supporting our clinicians, in innovation to make things better, and in offering more choice to parents and ensuring there is consistently high-quality care throughout the country. One of the main routes to achieving this is via our clinical strategies, including for maternity care, cancer care, trauma, mental health provision and many more excellent strategies. The problem is that those strategies have not, for some time, had the level of funding they need. This year, for the first time in many years, the national strategies were fully funded and the progress is evident to see. I am delighted to be delivering a further €62 million in new development funding for our national clinical strategies in the budget for next year. We are going to build on the progress that has been achieved thus far this year.

Other new funding for next year includes €45 million to advance the objective that care be accessible and affordable for the most vulnerable. There is €31 million for women's health measures. As I have said before, women's health must be, and is, a top priority for the Government. We have included a broad package of healthcare measures to this end in the budget for next year, building on the progress made so far in 2021. There is €37 million for a range of measures to deliver safe, quality and patient-centred care. We have allocated €30 million in additional funding for health services for older people. There is €65 million in new funding for disability services, on top of which we have a €10 million once-off funding stream for Covid-19. We have allocated €24 million for mental health services. There is an additional €11 million for another 19 critical care beds, which will bring our total critical care capacity to 340 beds by the end of next year. I have Government agreement to keep pushing on after that to bring us up to the level of critical care capacity we need. In addition, there is €9 million to fund accessible contraception for women. We are starting with those aged 17 to 25, the intention being that we move beyond that thereafter.

In spite of all this progress, we need to be honest that serious challenges remain to be faced. As colleagues are aware, three of the 112 Sláintecare projects were reported as having significant challenges. One of these is tackling waiting lists, which I have discussed. Another challenge is the implementation of regional health areas, RHAs. There has been progress on this in recent months. We have had research into international best practice and policy options have been drafted. Consultation has taken place with stakeholders, including patients, clinicians, policymakers, hospital groups and community healthcare organisations, CHOs, and further consultation is planned in the coming weeks. I am establishing an advisory group on this issue. We must ensure we arrive at a structure that works, first and foremost, for patients, while also working for the people employed in our healthcare system.

Our public health system is not where we need it to be when it comes to e-health, which is the third of the three Sláintecare projects that were deemed to have significant issues. There must be much more progress in this area. That progress was negatively impacted by the need to prioritise ICT and e-health resources in support of the pandemic response and recovery from the recent cyberattack, but it would be wrong to solely blame those issues for where we are on e-health. Nevertheless, there has been some very encouraging progress in the past 18 months. Many of the initiatives that were introduced in response to the Covid crisis, and the necessary measures to adapt to it, will stay in place after the pandemic to support a wider agenda. It is anticipated that the next report will reflect a shift towards business as usual for e-health as the impact of the pandemic and cyberattack starts to recede.

When I spoke recently at the joint committee, I noted that there would be some changes to governance structures. A new programme board co-chaired by my Secretary General and the head of the HSE, and comprising other members of our senior teams, is being constituted and will have its first meeting in the near future. This new board will ensure that there is high-level accountability for implementation and that the drive for universal healthcare is fully embedded in both the Department of Health and the HSE. This is a really important and ambitious project. The concept is fairly straightforward, namely, the delivery of high-quality care when it is needed. Getting there is not so straightforward and achieving it requires that there be full ownership by the senior teams right across the healthcare community. Access to high-quality healthcare when it is needed cannot, and must not, be a privilege for those who can afford it. It must be available to every girl, boy, woman and man regardless of how much money they, or their parents, have.That is what universal healthcare means, that is what must be delivered and that is my absolute focus in healthcare.