Wednesday 30 January 2013
The Minister for Health, Deputy James Reilly, has left the Chamber, but I will respond to Deputy Billy Kelleher’s remarks. There are 1.8 million people with medical cards, the highest ever figure. As chairperson of the Oireachtas Joint Committee on Health and Children, I give the Deputy an assurance that we will invite HSE personnel with responsibility for medical cards to attend. We will discuss the issues of discretionary medical cards and doctor groups and examine how these personnel adminster the scheme to provide medical cards for those who require them. I share the Deputy’s views and concerns, in particular that patients with cancer should not have to endure hardship, suffering and pain of being told by the HSE they cannot have a medical card. As the Deputy knows, committee members have been to Finglas and will return there. We will bring in the relevant personnel to discuss the issue with them.
People must be at the heart of our system. In this regard, I refer to patients and service users.
I highlight the fact that the Minister for Health is delivering reform. There has been a massive outcry on the part of his predecessors, those who served in previous Governments and those on the Opposition benches about what he is doing on the issue of reform. I ask those to whom I refer to reflect on what they did and achieved when in government. If a Minister cannot make decisions or prioritise projects, he or she should not be in office. Certain Members opposite sat in Departments and, as Ministers or Ministers of State, made decisions about prioritising and fast-tracking projects. That is the way it should be.
We endured 14 years of procrastination and obfuscation under successive Fianna Fáil Governments. Reports were compiled; committees were established, and there was “mockya” reform. Money was thrown into the black hole that was the health system. We are spending €13.4 billion on the health system. Ireland is not the state of California, the continent of Africa or the continent of Europe. It is only part of the continent of Europe, but it is spending €13.4 billion on the health system. Is Deputy John McGuinness unhappy that the hospital in Kilkenny has been prioritised by the Minister? Was I unhappy that one of the Minister’s predecessors, Deputy Micheál Martin, invested in Cork University Hospital? The answer is no. I did not criticise that investment.
However, Deputy Micheál Martin and others are protesting about what the Minister is doing in carrying out his functions.
Let us get real and consider what is happening in the health system. What we are about is ensuring services will be delivered, despite the fact that there is no additional money available. Those who operate the system do not have the luxury of being able to inform people that they can be replaced or take on extra staff. There are tremendous people within the Health Service Executive who work tirelessly on behalf of patients and citizens. I express my appreciation of the work they do.
I am very much aware that the time for procrastination and indecision is at an end. We can no longer afford these luxuries. We cannot endure pontificating and posturing from people who should know better. If we are to play the political game, we should all submit freedom of information requests and table parliamentary questions on what previous Ministers for Health achieved.
The era of boom and bloom was brilliant, but even when things were good, Fianna Fáil refused the chalice that was the Department of Health. Deputy Micheál Martin could not wait to get out of the place. As Bertie Ahern could not get one of his own gang to become Minister, he appointed Mary Harney who lay prostrate before the sacrificial altar of Fianna Fáil and said, “I obey and will take responsibility for the Department of Health.” Consider what happened to her. Brian Cowen referred to the Department as Angola. We now have a Minister who wanted the job and is prepared to make difficult decisions on reforming the HSE, but those to whom I refer are all saying he is not the right man, that he should not be there and that it is not his job to make decisions on projects. Deputy James Reilly is the Minister and the buck stops with him. People must get real.
The Minister has clearly indicated that the patient must be at the centre of everything we do in the health system. Fundamental change is coming, but it takes time to achieve. This is the beginning of another process of change initiated by the Government, the Minister and his Ministers of State, Deputies Kathleen Lynch and White. There are vested interests in every area of society. In the context of health, these vested interests must consider the bigger picture rather than seeing matters through the prism of their own perspective. Patients who require medical cards or need to access services or care or who need to have procedures carried out must be placed at the centre of all we say and do.
Deputy Billy Kelleher, as is his right, quoted a number of figures, but I wish to focus on what the Minister said. First, 3,500 adults were waiting for inpatient and day case surgery at the end of 2011, but within one year that number had been reduced to 89. In other words, the waiting list was cut by 98% in a single year. The Minister also indicated that 1,759 children had been waiting for over 20 weeks for inpatient or day case surgery at the end of 2011. Within one year the number of children on the waiting list had been reduced to 89, which represents a cut of 95% in a single year. The Minister further stated 4,590 patients had been waiting over 13 weeks for a routine endoscopy procedure at the end of 2011. Within one year the number on this waiting list had been reduced to 36, a cut of 99%. To borrow the Fianna Fáil slogan of old, it is a case of “A lot done, more to do”. We are aware that everything is not perfect in the health service. However, people must consider the position from which we began and the mess we inherited.
The Members opposite are fair-minded individuals and will give credit to the Minister for the job he is doing and what he is trying to achieve. We do not have available to us the same amount of money that was available to our predecessors, but we are still spending €13.4 billion on health services. There are challenges to be addressed. Let us consider what happened in 2012. The Chairman of the Committee of Public Accounts, Deputy John McGuinness, will, I hope, agree with me that in the context of public service renewal, there has been a buy-in by staff in respect of how business is done in the health sector. It is a credit to health care professionals, nurses, doctors and those who work within the health care system that the numbers of admissions, day case and other procedures carried out and services provided have increased. This could not have happened without a buy-in and agreement on the part of staff who have demonstrated great flexibility. We must ensure such flexibility is spread across the health care system.
One of the biggest gripes we had during the 14 years when Fianna Fáil, the Progressive Democrats and the Green Party were in government was related to the lack of accountability within the health care system in the delivery of services. Deputy John Halligan is right, the regional health fora, on one of which the Acting Chairman, Deputy Michael McCarthy, and I, served, were the greatest waste of time in the history of democracy. These fora which were mere talking shops ensured people’s democratic right to be represented was blunted. People from the health service were brought before the regional health fora to make presentations and answer questions. However, the fora had no powers. In addition, there was no accountability. Accountability is a must in the health care system.
We must ensure we get matters right in the context of the creation of the new child and family support agency. I hope the Minister and his Department will, in conjunction with the Joint Committee on Health and Children, consider how we should proceed in that regard. The proposed new directorate of mental health is most welcome.
The Minister is in charge of his brief and wants reform to be achieved. People should join him in that task, rather than criticising him.