Rebecca Moynihan (Labour) | Oireachtas source

I thank the Minister for coming in and I thank the Leader for facilitating this debate on Sláintecare. She had indicated that it would also be a wider debate on health and the health service. Health is a perennial issue in politics and, despite massive increases in health spending over the past 20 years, it is difficult to see the impact of this money or where it has gone. In a spending review conducted last year, it was determined that an additional €324 million would be needed in 2022 just to keep the health service running as it is. As Senator Gavan said, half of the issue is the significant turnover in staff among nurses, consultants and GPs. There is great difficulty recruiting them. Staff are not being retained within the health service because people are under such pressure.

Sláintecare was developed on a cross-party basis with the aim of reforming the system, ending the complicated two-tier system we have and ensuring that waiting lists and access to treatment were based on need rather than ability to pay. It is a laudable concept that the Labour Party is fully supportive of. It was never going to be easy and it is not now, particularly as three key members of the implementation group have resigned in recent months. Sláintecare needs both dedicated funding and political leadership. It needs to be driven and not just left to fall apart. There has been a sense in the past few months that Sláintecare is directionless and lacks advocates at governmental and administrative levels, where such advocates are needed.

My colleague, Deputy Duncan Smith, said that the setting up of a separate group to advise on the regionalisation aspect of Sláintecare is not in the spirit of achieving the aim of full system reform. It was the leader of the Minister's party, when he was Minister for Health and Children, who initially abolished those regional assemblies under the reform programme and the Hanly report. Despite this, we are now going back to that system and this Fianna Fáil Government is setting up a dedicated unit to have a look at just that rather than at the systemic reform needed. There is political support for Sláintecare but we need political will at the governmental and administrative levels to ensure its success.

With the indulgence of the Leas-Chathaoirleach, I will highlight another matter relating to healthcare, as the Leader has said this is to be a wider debate on the health service. I refer to the ownership of the national maternity hospital and the need to ensure the ethos of that hospital is secular and based on need and that it provides all of the services we need, given the investment the State is making in it. We need guarantees that there will be no religious ethos attached to the hospital. In the context of the protest for better maternity care, I find it quite striking that, even though the Taoiseach and the Minister for Health have said that they want to allow partners in, local decision-making has differed significantly from that sentiment. It raises questions as to who is control of the health service and health system. It would be an enormous missed opportunity - and it is a once-in-a-generation opportunity - to allow the St. Vincent's Healthcare Group to be behind the new national maternity hospital, although it is badly needed and is being built on a site that allows for co-location with another hospital. That presents a great danger. When we founded our health and education systems, we did not do it on a State basis such as can be seen in the creation of the National Health Service in the UK. Instead we essentially subcontracted these systems to the church. We are doing that again in this case. In building the new national maternity hospital, it is important that we ensure that it is State-led and secular and that it provides all of the services that people in maternity hospitals may need, including trans healthcare services, abortion services and reproductive health services. I cannot overemphasise how important that is.