Frances Black (Independent) | Oireachtas source

I wish the Minister a good evening. He is very welcome to the Chamber. I thank him for taking the time to be here with us I can imagine how busy he has been. It has been an incredibly challenging 18 months for all parties. There is no doubt about that. I acknowledge the Trojan efforts of the Department, the health service and NPHET to keep us all in good health throughout this pandemic. The roll-out of the vaccination programme is an area of particular success. Ireland's place at the top of international vaccination tables in a testament to this good work and to the commitment of the people to keeping one another safe. The pandemic has placed great additional pressure on the Department and the health service, as evidenced by the number of people with Covid-19 in hospitals and ICUs and the number of people awaiting treatment on waiting lists at present. It is important that, over the coming weeks and months, we remain vigilant and mindful of one another. Doing so will ensure our hospitals have the capacity to provide the services required by their patients throughout this next phase of the pandemic. I must give a big shout-out to our front-line workers, who are just incredible. I am proud that they have done such a phenomenal job.

Our health service is in need of significant reform. This was also the case before the pandemic. The pandemic has forced some of our systems to modernise and become more streamlined but significant deficiencies remain. Our hospitals struggle with capacity each winter. There seem to be accounts of individuals being treated on trolleys in hospital corridors every year. I have seen it with my own eyes when my sister was taken into hospital. It was like a war zone. It was scary and frightening. Our waiting lists for treatment remain some of the longest in Europe, with individuals waiting years for critical health interventions and support.While the pandemic has indeed placed a significant additional strain on the health system, its reformation simply cannot wait any longer. The implementation of Sláintecare is critical to this reform and to the creation of a health service which is fair, equitable and efficient. While I understand that progress has been made in many areas of the implementation plan, I am concerned that three key elements have not yet progressed to a significant extent, namely, the re-establishment of regional health areas, the tackling of hospital waiting lists and the development of the e-health programme. Progress in other areas will be held back by the slow pace of progress in these areas, and the current system, which is inefficient and discriminatory, will be maintained. The slow pace of progress in these areas was named by Laura Magahy as a significant concern in her resignation as executive director of Sláintecare in early September. I must say that I was most concerned to learn of her resignation. This was compounded by the resignation of Professor Keane and, subsequently, Professor O'Connor from the Sláintecare implementation advisory council. I do not want to be an alarmist, but if senior officials involved in the implementation of Sláintecare do not have confidence in its progress, it is cause for concern.

I welcome the fact that the Department has been working on a new delivery mechanism for Sláintecare in recent weeks. However, I would like some assurances from the Minister of State on what the mechanism specifically entails, and detail on who will hold it to account and when we might see progress in the three key areas of regionalisation, reducing waiting lists and developing e-health. It is also important that the progress of Sláintecare is not tied to the day-to-day management of the health service. I understand that the pandemic poses a once-in-a-generation challenge for the Department and the health service in this regard, but Sláintecare must be progressed so that the system is better prepared for any future public health emergencies.

We must engage in long-term thinking, planning and strategising in political decision-making in Ireland. The difficult decisions must be made now to ensure we do not need to make difficult decisions in future. We cannot continue to kick the can down the road. The pandemic provides a justification for doing so, but we cannot abandon long-term planning for what is an undefined period of time. The public health emergency will end at some point in the future, but we must ensure it does not leave another public health emergency in its wake in the form of an inefficient, two-tier health system that is stretched beyond its capacity. I know that the Minister of State is working to prevent this, but we need to hear more regarding the specific strategies and mechanisms that are being put in place to ensure we achieve a fair, equitable and efficient universal health system in Ireland in the not too distant future.