Tá mé ag filleadh ar an cheist a d’ardaigh an Teachta Shortall maidir le Sláintecare. Is polasaí é a foilsíodh i mí na Bealtaine 2017 nuair a bhí an Tánaiste ina Thaoiseach ag an am. Bhí sé lárnach sa phróiseas. Is polasaí é atá teipthe ina iomláine ag an Rialtas go háirithe de réir fianaise na mbeirteanna sinsearacha a d’éirigh as a bpost le déanaí.

I am returning to the subject raised by Deputy Shortall. I read about it with disbelief. The resignations were shocking enough, but even more so was the manner in which the Government has dealt with them. The Minister, Deputy Michael McGrath, has come in here today and once again minimised the issue, putting the blame on Covid.

In addition to housing, health was the biggest issue for all of us in the past three elections, from 2011 onwards. In 2016, my group sent a member to the committee which worked on a cross-party basis to produce the Sláintecare report. Rather than come in and continuously complain and highlight deficiencies, which I am acutely aware of in Galway city, we went with the cross-party report, which was finally produced in May 2017. There were 46 key recommendations in the report covering many areas, one of which was the recommendation to roll out a regional framework. Since then, we have had the resignations of two senior figures and a third resignation, that of Professor McCarthy from the South/South West Hospital Group. What did Tom Keane say when he resigned? He said that "the requirements for implementing this unprecedented programme for change are seriously lacking." We do not know what Laura Magahy said, because when she met the Minister for Health it remained secret with him, although when he came out of the meeting his spokesman described the meeting as a "standard meeting around lots of issues" and looking at "various elements of the ongoing reform." That was the comment made about the Minister's meeting with Laura Magahy. The Minister for Public Expenditure and Reform stated earlier that there had been a meeting with Tom Keane. When did that meeting take place? Are there minutes of it? I understand the gentleman in question is out of the country.

I come from Galway city. Many people have suffered and are suffering as a result of public-private medicine and the failure to invest in public medicine. As Deputy Shortall said, Sláintecare was to be the blueprint for reform. I have repeatedly pointed out that it is unusual for doctors and consultants to write to us, but they have done so in Galway to tell us of the extraordinarily long list of people waiting, for example, for orthopaedic surgery following bone breakages. I have lost my train of thought because so much has happened in that time. Two theatres went out of action in 2017 and I understand they are now being built.

Rather than me coming in here on a regular basis talking about trolleys, long lists and letters from doctors and unions prior to Covid, outlining to us the delicate state of the health system, could the Minister please explain to us what the Government has done about the two senior resignations and the third one from Professor McCarthy from the South/South West Hospital Group?

I mentioned Covid-19, not as an excuse, but as a reality. The reality is that 5,179 people have died in Ireland with Covid-19. There have been points over the past 18 months when our system was under real strain, and we got through that thanks to the heroic work of our front-line workers in the HSE, allied health professionals and others working across the system. Despite that extraordinary strain, which we hope is a once-in-a-century level of strain that any health system would have to withstand, we have made real progress. When one looks at the report Laura Magahy brought forward - the implementation update in respect of Sláintecare - of the 112 deliverables for the first six months, 84 were on track, 25 were being progressed with minor challenges and three were experiencing significant challenges. That is 97% of those actions either delivered or on track. In the context of what we have had to live with, and what our system has had to coexist and grapple with over the past 18 months, that is a remarkable achievement. I look at the once-in-a-generation increase in the capacity of the health system, with the sanction provided for well over 1,000 additional beds in the acute hospital system. We do not have 20,000 beds or 30,000 beds; we have in the region of 11,000 beds. That is a dramatic increase and a step change that we have made in respect of critical care capacity as well.

The learnings of Covid have been relevant because we are going to have to future-proof our system for events like this that could well arise again. The Government is committed to the transformation of the public health system. It is not going to be easy and there will be challenges along the way. We must assess the reasons the resignations took place. That is why the Minister has had direct discussions with Laura Magahy and Professor Tom Keane and met the Sláintecare implementation advisory council. In the forthcoming budget we will see a further manifestation of the Government's commitment to delivering on the reforms.

Change is not easy but it is certainly not easy when one is living with a global pandemic that has taken more than 5,000 lives in this country. Our commitment is resolute, and it will be brought to bear and implemented through the decisions that we make working with all of the stakeholders across the health system.

There was no Covid in 2017. When the report was launched, it was because it was urgent and necessary. When did the Minister meet Tom Keane? Will the Minister please clarify that? When did that happen?

Regarding the roll-out of this programme, I hope I never hear a Minister stand up here again and use the deaths of people from Covid as an explanation for why there was no progress on the implementation of a plan that was necessary because of the deaths and illnesses of people who were suffering as a result of a completely dysfunctional health system. That is what we are looking at here. In Galway city, two orthopaedic theatres have been out of operation since 2017. Regionalisation is necessary, although we have gone through the dance before of the circular health boards - we abandoned them, brought in a health executive, had a board, abolished the board, brought the board back and now we are going back again to regionalisation. Covid did not stop regionalisation; a lack of willpower did.

Sláintecare should be located within the Department of the Taoiseach. Where is the interdepartmental committee with oversight? Where are the minutes of that committee? How often did it meet? Who is pushing this, notwithstanding that we must deal with Covid as a country?

The Minister, Deputy Stephen Donnelly, spoke with Professor Keane over the phone because he is in Toronto. He has spoken on more than one occasion with Laura Magahy since her resignation took place. He has spoken and met with the implementation advisory council and will now consider its request for an extension of time. We will consider that in the context of the consideration of what we need to do to strengthen the governance arrangements in respect of Sláintecare implementation. We are determined to get this right, ensure the governance is as strong as it needs to be and any obstacles and roadblocks in the system are removed because they are not at a political level. That is the commitment of the Government. We are providing the resources. Why does Deputy Connolly think we do not want to implement Sláintecare? We do. The increase in the capacity of the system that we have provided lays a very solid foundation for those reforms. The lack of capacity has been the single biggest weakness in the system in recent decades and it had to be fixed first. We are now well on the way to fixing that and we will make further progress on it across 2022.