Friday, 24 July 2020
Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020: Committee and Remaining Stages
I raised this issue when the Minister was Opposition spokesperson on health. The reform of the HSE is going to be critical to his term as a Minister. Mr. Paul Reid brought a certain dynamism to the role. In the Minister's reply to us, he spoke about the challenges we face in a post-Covid world in terms of access to outpatients and elective treatment. This where a constitutional convention or citizens' assembly around our health sector is important. I do not want to delay the House but for me this is an important issue. Health politics captures most Ministers. It captures every person in the Houses. Back bench Deputies and Senators are lobbied from here to wherever about everything, including big pharma, hospitals, local action groups, GPs or whatever. I do not know that the Oireachtas Sláintecare committee fully grappled with what Sláintecare could do. The Minister might say I would be critical because Members of the Upper House were excluded from the committee but that is not the case.
The constitutional convention approach would mean that we gather international experts from at home and abroad, North and South, to tackle the issue of health. The Minister will find now that with €17 billion divided into different silos, which is now €20 billion because of what unfortunately happened with Covid-19, we will always be chasing. In his reply he mentioned the different challenges we have to address. There is universal hope now that because he has come in from the outside, the Minister will be able to tackle this. Paul Reid has come in from the outside as well and there is a new Secretary General in the Department of Health. We should congratulate Jim Breslin who I thought was a very good Secretary General in the Department of Health on his new post.
The reason I think the citizens' assembly approach could work here is that we saw with some of the social issues and with climate change the perspectives that it brought, away from the heat of the cauldron that is Leinster House and from the microscope being put by the media and others on the trolleys, waiting lists or whatever. I refer to what is happening at the moment with the NHS and the furore in the United States around the repeal of Obamacare. I think Senator Fitzpatrick mentioned going to dial one's health insurer in America. We were lucky in this country that we had the political acceptance in terms of Covid-19 to be able to do things that we would probably have never done in peacetime. We must look at the other parts of the world where that was not the case. There were fights over PPE, who got on a ventilator, who was going to pay. The Minister's legacy will be to bring reform again. James Reilly did a piece of work that has been criticised. The former Minister, Deputy Harris, did work, as did the Tánaiste, Deputy Varadkar.
The biggest mistake ever was to get rid of the old health board system because there was accountability at local level.We were able to argue about our own hospital or medical facility but that became lost in the HSE. I hope the Minister will give serious consideration to what I am asking. We actually have a fist-class health system. Those who criticise our healthcare system fail to recognise the quality of our staff and the positive outcomes we have in terms of heart and stroke care. I refer to our approach around obesity, smoking and alcohol. We have been pioneers on certain legislative frameworks around health. The one thing we are lacking is real accountability in our health service. Even when putting in a parliamentary question, as the Minister knows, it can take 12 weeks to get an answer to what we would consider a simple request. I ask the Minister to give that consideration. I thank the Cathaoirleach for letting me come in.
On section 6, Senator Conway made a very telling contribution in his Second Stage speech about what the medical card confers on recipients. We need to do a further piece of work on the packages we can bring with that. I hope that in a further debate on health we may be able to embrace what Senator Conway spoke about in terms of the medical card. It is that passport. The Minister spoke about the importance of teenagers and those under six years of age. Our world has changed since 1970. Young people and teenagers are at that point now where life has evolved from when we began the medical card system. I am asking the Minister to look at that age group. There are myriad issues going on their lives in terms of puberty, new schools, new subjects, sexuality; one could go on. The passport the medical card provides is something we should develop and put a suite of packages around. I hope we can do that.