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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

Sláintecare legislation and targets

Summary

Deputy Harty asked when legislation would be introduced to place Sláintecare access targets on a statutory footing. The Tánaiste said implementation will take years, resources must match any legal targets, and the Government is increasing health spending and staffing while he offered to seek a specific answer from the Minister for Health.

My question relates to the dysfunction in the health service and, in particular, to the Sláintecare report and the reforms that flow from it. A key recommendation of the report was that legislation be introduced in 2018 to place guarantees on access to care on a statutory footing. Such legislation should provide that patients will be seen within 12 weeks for an inpatient procedure, ten weeks for an outpatient appointment and ten days for a diagnostic test. When will that legislation be introduced to meet those targets?

Comment on this
Simon Coveney The Tánaiste Fine Gael

With respect, the Deputy will have to ask the Minister for Health that question, although I can ask on his behalf and revert to him if that is helpful.

Our focus is to implement Sláintecare, which will take about ten years. We are two years into that process now. For the first time ever, we have cross-party consensus on the kind of reform needed throughout the health system. We are putting significant resources behind the plan to get it done but it is not going to be done overnight. As we provide services, we also hope to be able to introduce new legislation to maintain those services in terms of timelines, standards and so on. Next year's health budget will be €1 billion more than this year.

Comment on this

No, it will not. The figure is €600 million.

Comment on this
Simon Coveney The Tánaiste Fine Gael

That includes some of the additional spend this year that had not been budgeted for, which I accept that, but it is still well above €650 million extra next year for healthcare, reflecting the capital and current expenditure pressures that we face.

Comment on this

We are running to stand still.

Comment on this
Simon Coveney The Tánaiste Fine Gael

We are making progress here. We are spending more money and introducing a reform programme that everybody in this House buys into. We would like to do it as fast as possible but it is going to take time. We are in year two of a ten-year plan.

Comment on this

I understand that the Tánaiste is not the Minister for Health and I do not expect him to have a specific answer to my question. The point I am trying to make is that targets will not be met unless there is legislation to underpin them. Targets will not be reached voluntarily. The Government must provide an incentive so that targets will be met. Of course, Sláintecare cannot be delivered overnight but the question is whether the Government is willing to introduce legislation that will demand that targets are met. Outpatient numbers are increasing and the demand for elective care is also increasing. Soon the only elective care that will be delivered in our acute hospitals will be for trauma, emergencies or cancer. Elective care is slowly being pushed off our hospital waiting lists. Soon we will have a winter initiative under which elective care will be cancelled for between six weeks and two months, which will only add to the lengthening lists. When a patient moves from an outpatient list, having eventually been seen, to the inpatient list, he or she moves to the bottom rung of that list. Legislation must be introduced to impose targets and to demand, by way of statute, that care is delivered in a timely fashion. When will that legislation be introduced?

Comment on this
Simon Coveney The Tánaiste Fine Gael

If there is clarity on that in the Minister's office, I will forward it to the Deputy but if we are going to pass legislation, we must make sure resources are available to deliver it, otherwise, something will be passed that cannot be delivered, which does not make sense. If we introduce legislation to protect patients and ensure that targets are met, we must also make sure the resources are in place, including both human and capital resources, to make it happen. This budget will result in 1,000 additional staff based in the community. Recently, an additional €20 million was provided for the Sláintecare integration fund. There is also a significantly increased input from GPs in improving community care and keeping people out of hospital so that we can create space for the kinds of elective treatment to which the Deputy Harty referred. That reform is under way and those funds are supporting the reform programme. In the context of the legislation to which he referred, we must make sure that if we are going to pass laws, we have the resources in place to ensure compliance with them.

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