Jim Daly (Cork South West, Fine Gael) | Oireachtas source

We have to assess why we are not getting the results we want. The Deputy could read the Sláintecare report, which goes a long way towards answering the question. It identifies the steps towards addressing the problem, and shows how we can spend the same amount but achieve much better outcomes. Essentially we are dealing with an infrastructure which was designed long ago and which is not fit for purpose any more, as I referred to earlier. That is true in respect of the design of the administrative aspect of the HSE and how it was set up initially, and the lack of IT and lack of investment in infrastructure over the years. Capacity is an issue that countries with a similar population do not have. We face severe capacity issues in our acute and community settings, and are trying to reorient services back towards the community from the acute setting in that respect. Sláintecare is probably the best answer to the question the Deputy asked. The reorientation would be provide much better value for our money, and Sláintecare is the ten-year plan we have identified which will make that happen.

I often ask people to consider how far mental health services have come under A Vision for Change, which was also a ten-year plan. In the 1960s, there were 20,000 people in long-stay, inpatient, acute psychiatric beds. Today there are less than 1,000. We have made significant reforms towards community-led service in mental health, and I have no doubt that we can do the same with physical health if we apply the same vigour to it over that ten-year period and embrace Sláintecare, regardless of which politician is occupying a particular chair of office over those ten years.