Speeches
Speech by Fiona O'Malley on the Health Bill
Speech by Progressive Democrats TD Fiona O'Malley on the Health Bill 2004, Wednesday 24th November 2004
This is a most welcome bill. Its gestation has indeed been long, beginning with the publication of Health Strategy in 2001, and now as it faces into labour and what we can only hope is a safe delivery, the opposition has already orphaned it.
The bill's modest size belies the depth and breath and strength of its effect. It aims to consolidate the fragmented structures which currently constitute our Health Service. And I doubt anyone would not applaud and support such a radical approach. Few are the people who want the health service to remain as is. But they all seem to inhabit this house.
I listened yesterday to the opening of the debate from the opposition spokespersons and I was struck by the lack of passion in the contributions. A lack of passion, combined with a lack of a coherent or convincing challenge to the purpose and effect of this bill. It was posturing and opposition for its own sake.
We are all too aware of the failings of our current system. A towering edifice of bureaucracy, which successive Ministers of Health have toiled in vain to contain.
In fact, the system had become something so large and so unwieldy and so impenetrable, that no Minister wanted to take on the task of reforming it and shirked challenge instead. It is fortuitous indeed that finally we have a Minister with not just the courage, but also the ability and the determination to bring order to the nation's health care service and to do what is necessary and what is right by it: to put the patient at the centre of its operations. Deputy Twomey put his finger on it last night when he referred to Minister Mary Harney as the Minister for Reform!
This bill represents, to an extent, the enabling or the enacting of the copious reports that were commissioned by the Department of Health in recent times. It is high time that such reports, having been commissioned at such a cost, were implemented and this is exactly what we are getting with this Bill.
The case for reforming the structures of the health service is compelling. We need a health service that is responsive and appropriate to the needs of the 21st century. That is accessible to all. That puts the patient first. If the structures and functions of the current system are not organised or capable of delivering the ambitions of the Health Strategy then it is time to change them.
The provisions of this bill will see the consolidation and rationalisation of a multitude of agencies into the Health Service Executive. This will invest in this corporate body the authority to implement Government policy through a more streamlined system - thus ending the fragmentation that characterises and undermines the current system.
As the Prospectus Report proclaims “a better planned and managed health system should deliver measurably improved healthcare to all its patients and consumers.”
The present health system has been in existence for 30 odd years and is creaking under the strain. Its inability to cope is best demonstrated by the absence of an improvement in service or output, despite the significant increases in investment, which the service has received.
The introduction of this bill to the house is our opportunity to make massive strides in the provision of healthcare, to put in place modern management systems to extract greater efficiencies from the considerable resources Government applies to the sector. To put in place a new system where the patient will placed at the centre of services and where outcomes can be measured.
The establishment of the Health Services Executive (HSE) to replace the 11 health boards and bring 27 separate health agencies in under the one umbrella is welcome indeed.
Am I alone in not lamenting the passing of the Health Boards? Surely not? I did not enjoy the privilege of serving on a Health Board and what a privilege it was. The most coveted of all the spoils the victors enjoyed in the post-election negotiations on the establishment of new local authorities.
For a country of 4million people, did we really need 263 people on 11 different boards spread across the country to make health policy? We do not have 11 different health systems in this country, and our system of governance should reflect that. The Bill will see a streamlined system of Governance and implementation of health policy. The job of the 166 Dail deputies and 60 senators will be to ensure that health policy best reflects the needs of constituents up and down the country – and by this I mean their real needs, not pump parish politics. I, and fellow members of the Health Committee, take our responsibilities very seriously – to hold the Government to account. There will be diminution of democracy and accountability with the New Health Services Executive. Every member of this House has a responsibility to scrutinise the workings of the system and I reject the notion that only councillors sitting on a health board could offer scrutiny of the health service and that somehow their removal would present a democratic deficit.
Deputy Rabbitte keeps referring to the New GP Medical card in a disparaging fashion. The GP Medical Card is an imaginative response to the realisation that many families need the reassurance that a visit to the GP with a sick child can give, where cost may have previously discouraged them from making a visit. The Tanaiste reminded Deputy Rabbitte in the House this morning of his own calls for such a service be provided….He will have to learn to hold on to his beliefs. He has a tendency to switch parties with alarming frequency. I am sure his inconsistency is causing disquiet among his colleagues in the “alternative coalition “.
Last night Deputy Liz McManus accused the Tanaiste of Gross Dishonesty. Such Gratuitous theatrics highlight the fact that the Labour Party have been wrong-footed by Tanaiste taking up the health portfolio and immediately implementing a reform agenda.
Indeed, Deputy McManus has been so wrong-footed she is now resorting to what can only be described as personalised attacks.
The Tanaiste is not just the Minister for Health and Children. She could equally claim for herself the title of Minister for Reform and Implementation. And together with the co-operation of the many thousands of employees who currently deliver care under a jaded system, she will build a better service where the patient is central to all decision-making, and it is a service that all Irish people can be proud of.