Micheál Martin
Ceist:2. Deputy Micheál Martin asked the Taoiseach the position regarding the implementation of the programme for Government; and if he will make a statement on the matter. [37633/14]
Amharc ar fhreagraTuesday, 27 January 2015
Ceisteanna (2, 3, 4, 5, 6)
Gerry Adams
Ceist:3. Deputy Gerry Adams asked the Taoiseach the position regarding the implementation of the programme for Government; and if he will make a statement on the matter. [39840/14]
Amharc ar fhreagra
Joe Higgins
Ceist:4. Deputy Joe Higgins asked the Taoiseach his views on the implementation of the programme for Government; and if he will make a statement on the matter. [43818/14]
Amharc ar fhreagraGerry Adams
Ceist:5. Deputy Gerry Adams asked the Taoiseach the position regarding the implementation of the programme for Government.. [44836/14]
Amharc ar fhreagra
Richard Boyd Barrett
Ceist:6. Deputy Richard Boyd Barrett asked the Taoiseach if he will report on the implementation of the programme for Government; and if he will make a statement on the matter. [47832/14]
Amharc ar fhreagraFreagraí ó Béal (38 píosaí cainte)
I propose to take Questions Nos. 2 to 6, inclusive, together.
The programme for national recovery, which was published in 2011, is a five-year plan that sets out the Government's detailed and ambitious work programme to restore the country’s finances by building on a platform of strong economic management, job creation and a comprehensive reform agenda. Much has been achieved since then. Ireland successfully exited the bailout programme in December 2013. The Irish economy has returned to sustainable growth. Some 80,000 new jobs have been created since the first jobs action plan. Unemployment continues to fall and is now at its lowest rate since 2009. The number of homeowners in mortgage arrears is falling. More than 89,000 permanent restructures have been achieved. The Government has set out a range of measures under the Construction 2020 strategy to get the property market moving, to generate building activity and to increase supply, thereby easing the pressure on those in negative equity. A major programme of public service reform has delivered significant pay savings, increased working hours, increased efficiencies through use of shared services and centralised procurement. A new Civil Service renewal plan has been launched. The significant reform in how services are delivered has already seen the streamlining of local government structures, the establishment of a new Court of Appeal to reduce waiting periods for complex cases and the overhaul of bankruptcy legislation.
Last July, the Government published its statement of priorities for the period from 2014 to 2016, which sets out the key priorities that will continue to drive forward the agenda for the economic and social recovery of Ireland. These additional actions, building on the commitments in the programme for Government, will ensure the recovery translates into meaningful and positive change that affects the lives of people and communities. In March of each year, the Government publishes an annual report in which it sets out the progress it has made in implementing the commitments made in the programme for Government. It has published three reports to date, reporting progress on 80% of those commitments. Work is under way on the fourth report. This will incorporate the progress made on the additional commitments set out in the new statement of the Government's priorities. As in other years, this report will be published in March. As a Government, we have and will continue to work hard to implement the commitments in the programme for Government to ensure Ireland remains firmly on the path to full recovery in the time ahead.
We have four Deputies wanting to ask questions.
I appreciate that, a Leas-Cheann Comhairle. I thank the Taoiseach. I submitted this question because I have been puzzled for quite a long time about the enormous gap between the reality on the ground regarding the implementation of the programme for Government and the actual programme itself. Nowhere is this more evident than in the "health and mental health" section of the "fairness" chapter of the programme for Government, which begins by saying "this Government is the first in the history of the State that is committed to developing a universal, single-tier health service, which guarantees access to medical care based on need, not income". That was supposed to happen under this programme during the duration of this Government. The programme for Government continues:
This Government will introduce Universal Health Insurance with equal access to care for all. Under this system there will be no discrimination between patients on the grounds of income or insurance status. The two-tier system of unequal access to hospital care will end. The Universal Health Insurance system will be designed according to the European principle of social solidarity: access will be according to need and payment will be according to ability to pay.
It contains a promise that the Government "will act speedily to reduce costs in the delivery of both public and private health care and in the administration of the health care system". I am sure the Taoiseach is aware that the cost of private health care has soared in the past four years. The programme for Government also promises that "a Special Delivery Unit will be established in the Department of Health". That was set up but has now been run down. The programme also talks about "reducing waiting lists". We saw today's survey across Europe, which illustrates that public faith in statistics pertaining to waiting lists has collapsed. The programme for Government states that "a Patient Safety Authority, incorporating HIQA, will be established" but the Taoiseach has informed me that this will not happen now. The programme also states:
The Health Service Executive will cease to exist over time. Its functions will return to the Minister for Health and the Department of Health and Children; or be taken over by the Universal Health Insurance system. Staff will be deployed accordingly.
There is a whole page of commitments in the programme for Government with respect to primary care. In light of the promise that "Universal Primary Care will remove fees for GP care and will be introduced within this Government’s term of office", the entire population should be looking forward to the removal of fees before the Government's term of office comes to an end. This section of the programme continues:
The legislative basis for Universal Primary Care will be established under a Universal Primary Care Act. Universal Primary Care will be introduced in phases so that additional doctors, nurses and other primary care professionals can be recruited. During the term of this Government, GP training places will be increased. GPs will be encouraged to defer retirement and will be recruited from abroad, and the number of practice nurses will be increased [and so on] ..... Access to primary care without fees will be extended in the first year to claimants of free drugs under the Long-Term Illness scheme ..... Access to primary care without fees will be extended in the second year to claimants of free drugs under the High-Tech Drugs scheme at a cost of €15 million.
None of this has happened, of course. The Government has reversed its position in respect of the latter two promises. The section of the programme dealing with the proposed new GP contract provides that "under Universal Primary Care, GPs will be paid primarily by capitation".
A full page of the programme for Government deals with universal hospital care. It promises that "a system of Universal Health Insurance (UHI) will be introduced by 2016, with the legislative and organisational groundwork for the system complete within this Government's term of office". I will not go through all the issues because I know others want to contribute. This section of the programme states that "Exchequer funding for hospital care will go into a Hospital Insurance Fund which will subsidise or pay insurance premia" and that "The legislative basis for UHI will be established by the Universal Health Insurance Act."
The next page of the programme, which deals with hospitals, refers again to the hospital insurance fund. I went through all of these matters with the Taoiseach previously. This section of the programme states that "the Minister for Health will be responsible for hospitals policy" and suggests that insurers will "take over the running of hospitals" and "negotiate directly with hospitals to help control costs". The programme also speaks about the pathway to universal hospital care and the "legislative basis" for it.
The next page of the programme for Government, page 6, deals with care of older people and community care. It states:
Investment in the supply of more and better care for older people in the community and in residential settings will be a priority of this Government. Additional funding will be provided each year for the care of older people. This funding will go to more residential places, more home care packages and the delivery of more home help and other professional community care services. The Fair Deal system of financing nursing home care will be reviewed.
This page of the programme for Government also sets out the Government's plans for integrated care, cost control and health administration. The following page deals with capital developments in health and mental health. It promises to "review the Mental Health Act 2001" and "end the practice of placing children and adolescents in adult psychiatric wards". That has happened in some instances, although much of that work was done before this Government came into office.
In terms of bioethics, there was to be legislation on assisted human reproduction and stem cell research. I have written to the Taoiseach and asked him during Leaders' Questions about the Government's implementation in this regard. The bottom line is that little has been implemented. There comes a point at which the Government needs to be honest with the people and the Oireachtas. There is no point in printing an Alice in Wonderland-type programme for Government that will never see the light of day in terms of implementation. We have had reversal after reversal, breach of promise after breach of promise and a shambles of a scenario, as witnessed in today's damning indictment by the European survey.
I asked the Taoiseach about one line in the programme for Government relating to Cabinet confidentiality and read a couple of pages in a short section dealing with health. None of this has happened and there has been no attempt to make it happen. When the Minister, Deputy Varadkar, took over for the former Minister, Deputy Reilly, the current Minister stated that he would ditch much of this. The Taoiseach then took him to task and told him that he should not and could not ditch it. Will the Taoiseach confirm that none of this will happen before the Government's term comes to an end? The vast majority of commitments in health simply will not happen. It makes a mockery of the concept of a programme for Government. It is meaningless, and this is only one section. I could go through sections on education and so on, but the health section is a disgrace in terms of what it says will be done compared with what has actually happened and what the Government is doing. One need only consider the crisis in accident and emergency, the 800 people in beds who could not be discharged because of the lack of home care packages and the fact that this year's Estimate has reduced the number of beds in the fair deal scheme by 1,400 compared with 2013's figure. Some 1,400 fewer beds will be provided in 2015 than were provided in 2013 despite what the programme for Government says about more beds and more packages. The thing is a complete farce and the Taoiseach should acknowledge that.
If the Deputy wants a detailed response from the Minister for Health, he will get it in respect of many of the things he has commented on here. In respect of the Department I have myself, which is the Department of the Taoiseach, there were 44 commitments entered into in respect of the programme for Government and 40 and four in the revised statement issued last July. Three quarters of those have been completed or are substantially complete and work is ongoing in the other eight or ten.
The Deputy also mentioned the survey produced from a European perspective during the course of the week. As I understand it, this was based upon analysis of different surveys carried out by organisations as distinct from figures produced by the HSE. While the Deputy has always decried the references that parties have made to the Dutch health system, it is interesting to note that it comes out on top in most of these assessments. Ireland can be seen to perform well in patient outcomes - as well as France, Belgium and Denmark and better than the United Kingdom. These include important objective measures, Deputy Adams, such as death from stroke or cardiovascular diseases, cancer survival and infant deaths.
Those were all strategies from before the current Government came to power.
Ireland comes joint first when it comes to access and appropriate use of medicines and performs better than average on prevention, such as vaccination and smoking prevention.
That is all from before the Taoiseach's time.
We perform poorly in access and waiting times as well as patient rights and information. I think that has been acknowledged and accepted by the Minister, who is working at that now.
In many ways, the survey confirms that the Irish health system is actually very good once one can get access to it. That has always been the challenge here. I suppose that, at the end of the survey, it is also worth noting that some of the measures are very subjective. Our worst score in this survey is for our low rates of abortion. Many people would see that as a matter of opinion and ethics rather than something to be scored on in a survey.
The White Paper on Universal Health Insurance was published and the programme of health reform was progressed, including the roll-out of the concept of money follows the patient, the opening of many primary health care centres around the country on a continuing basis,-----
GPs are-----
-----the establishment of the hospital groups, which will eventually move into hospital trusts, the progress that was eventually made on the national children's hospital, which will go for planning permission as one of the most major pieces of infrastructure in the country for very many years, and of course the difficult enactment of the Protection of Life During Pregnancy Act.
There are many other areas where progress clearly has been made, but I am the first to admit the challenges that are there for the Department of Health and the HSE. That is an ongoing challenge. I hope that the efforts now being put in place by the Minister for Health and by the Minister of State will regularise the delivery of health systems and health services that will deal with the challenges that are out there in a way that people will get their medical attention as rapidly as possible and based on their needs. It has never been something that one can just deliver overnight, as Deputy Martin is well aware. I suggest that we can get him a more comprehensive response to all of the many issues that he has raised on the four pages.
I got those responses. According to all of them, nothing that I have mentioned will happen.
In respect of-----
Many of the legislative measures and proposals in the programme will not happen. There has been a change in policy. The programme for Government should be realistic.
It is true to say, though, that, in respect of the Department of Health, the entire question of universal health insurance is one that is contingent upon a whole range of things happening, like money follows the patient. The issue that has been outlined on so many occasions, the legislative base for it, the insurance companies, the negotiations directly with hospitals, the setting up of hospital groups evolving into hospital trusts, the provision of an adequate community series of health services from home care packages to nursing homes, all of these areas-----
Less is being made available. Does the Taoiseach not know that?
I must make some progress.
We have been upfront about it,-----
The Taoiseach is not being upfront about it. There is less.
-----saying that the introduction of universal health insurance is not possible in the lifetime of this Government because all these segments have to be put back into place. The White Paper has been published. Obviously, there will be a follow-through on that. Many of those issues that Deputy Martin read out are contingent upon the entire process of universal health insurance - competing insurance groups, people having the right to choose between the insurance companies, the requirement for hospitals to compete with one another on an equal footing, the compensation for public hospitals and so on. It is not a sort of black and white series of issues that one can just put together like that. It is an evolution of an entire series of structural changes in the interests of the people and of the taxpayer so that they might get the very best quality of health service delivered to them as locally as is possible.
I will have to group questions because we are running out of time. Deputies Adams, Higgins and Boyd Barrett are next.
I commend and thank the Taoiseach for the unusually clear way in which he dealt with the question about Cabinet confidentiality. Under the programme for Government, that was to be legislated for, but the Taoiseach has stated that he has no plans to legislate. He could be of some service to the State if he entered the Chamber one day with the programme for Government and took the same approach. That would save all of us a large amount of time. I commend this suggestion to him.
I will deal as briefly as I can with two important issues contained in the programme for Government, one of which is health. There is a range of measures and promises to provide for a new health system. The results of this are evident in the Euro Health Consumer Index, which sees the placement of our health services drop by eight points from 14th to 22nd. Furthermore, it finds that the Government's waiting list data "lacks credibility". Last Friday, the Minister for Health produced his health priorities.
His seven priority areas and 85 specific actions or deliverables are basically the same, and as many as were in the programme for Government for almost four years. Clearly, therefore, the programme for Government is not delivering on matters concerning health.
In respect of economic recovery, the programme states that, as a long-term goal, "The Government is committed to tackling Ireland's economic crisis in a way that is fair, balanced and which recognises the need for social solidarity". That commitment has not been delivered upon, however, for the 500,000 taxpayers who have been forced to flee overseas. Neither has it been delivered to the one third of our children who live in poverty, nor to the one third of citizens who cannot afford the basics. Instead, we have had water charges, property tax, cuts to child benefit, and extensive cuts to health and welfare. Thousands of vulnerable families have been traumatised by the Government's disgraceful handling of the medical cards issue.
I will not take up time because two other Teachtaí Dála want to contribute. I wish, however, to commend what I said previously. There is only so much the Taoiseach can do in a Government's term of office. Would he therefore not be better off telling us the things he is not going to do? That would allow us to focus on the things he is going to do.
The Taoiseach should learn from the history of implementing previous programmes for government, particularly concerning his target of raising €2 billion through the sale of State assets. Does he agree that traditionally the privatisation of State assets has been extremely destructive for our economy and for the public? The Telecom Éireann privatisation debacle, for example, was sweated by a succession of vulture capitalists. There was then a huge under-investment in broadband which is still a problem. Similarly, Team Aer Lingus resulted in the disaster of losing 1,300 highly skilled jobs after a few years of privatisation in the airmotive industry.
Will the Taoiseach rule out the sale of the State's share of Aer Lingus? A major international capitalist getting its hands on this crucial sector is a huge threat to jobs and the facilities at Heathrow. An island nation should have control over its air transport facility and, therefore, the Taoiseach should rule out selling the rest of what was the national airline. In fact, he should move towards re-nationalisation.
In the section dealing with the economy, the programme for Government states that, "The parties to the Government recognise that there is a growing danger of the State's debt burden becoming unsustainable and [I want to underline this bit] measures to safeguard debt sustainability must be urgently explored". That is a clear injunction.
Many of us are extremely disappointed and depressed by the Taoiseach's - to put it mildly - muted response to the election results in Greece. They are a beacon of hope to people who have been victims of austerity right across Europe. They have been battered for six years with what Paul Krugman rightly called "the fantasy economics of the troika". "Fantasy economics" is one of the Taoiseach's favourite phrases. Paul Krugman said it was the troika who were guilty of fantasy economics in believing that one could batter an economy, cut its public services to pieces, slash people's incomes, and have any other result than creating a nightmare for that society. How right he is.
When someone is finally willing to challenge the failed consensus of austerity, as the people of Greece have now been willing to do, and ask the question, "Can we explore debt sustainability?", the Taoiseach fails to endorse that call. In failing to do so, he is breaching his own commitment in the programme for Government to "urgently explore any opportunity to improve debt sustainability".
We are effectively acting as the scabs of Europe in breaking solidarity with debtor countries which have been crippled by austerity. In doing so, however, the Taoiseach is also breaking promises made in the programme for Government. In light of his commitments in the programme for Government, I ask the Taoiseach to reconsider the question of a debt conference and urgently exploring debt sustainability.
The consequences of that failure to explore debt sustainability are most acutely felt in sectors of society where the most vulnerable are at risk. As has been mentioned already, the state of our health service is one of the starkest examples of that. It is a serious breach in the Taoiseach's government commitments.
In the programme for Government's section on health, it states, "We must reduce the cost of achieving the best health outcomes for our citizens and end the unfair, unequal and inefficient two-tier health system". How does the Taoiseach square that with the fact that the Minister for Health had to admit last week that, in order to deal with the crisis in accident and emergency departments, waiting lists will lengthen, including those for non-emergency surgery? People who are already waiting intolerable periods for important operations, will now have to wait longer.
I do not know if the Taoiseach listens to his car radio but we are bombarded, literally every day, with advertisements from the Mater Private Hospital and the Blackrock Clinic saying, "Come to us. You can get immediate treatment. Whatever it is you need, you can get, if you can pay for it." Those who cannot pay, however, will be on public waiting lists for even longer because health budgets have been slashed.
That is a clear example of where the Taoiseach has failed in a commitment to end a two-tier health system wherein by dint of having money one can get decent health services, but otherwise one will languish on a waiting list or on a trolley. What will the Taoiseach do to fulfil that promise?
Deputy Adams raised issues he has raised before. I know he has to put on his-----
A Deputy
Angry hat.
-----public political face when he does his orations to the people. He will appreciate, however, that emigrants are returning to Ireland with new experience to avail of new job opportunities here. He recognises that unemployment has fallen from 15.2% to 10.6%. He also knows that unemployment lists have fallen consecutively for 30 months.
What about all the people who have gone away?
They are on their way back through Kerry airport.
He does recognise that interest rates have fallen from 15% to an average of 1.25%. He also recognises that while there is ferocious demand for housing at the moment, property prices are beginning to rise. He recognises a much stronger public confidence, as is evident in so many sectors. However, as I have said openly, that recovery is fragile. It cannot be fully completed if there is any complacency or any situation whereby we will lose those hard won gains.
Deputy Higgins mentioned the sale of State assets. He is quite right that the sale of Telecom was accompanied by loud shrieks and calls from all over the world at the time. It was subsequently asset stripped. This Government has made it clear that any State asset would be sold only in the interests of the public and the taxpayer.
When the troika was here, the agreement was that the majority of the moneys realised from any sale of State assets could be spent on the development of sustainable employment. If the Government examines the possibility of selling any State asset, such a sale will only proceed following careful consideration and will be in the best interests of taxpayers and the Irish people in general.
I answered questions earlier about Aer Lingus, a company which the Government does not own and in respect of which it must take into account a much broader set of circumstances other than a mere valuation of the extent of its shareholding of 25.1%. Deputy Higgins is well aware that the Government is but one component of the ownership of Aer Lingus since the company's privatisation by a previous Administration.
I must inform Deputy Boyd Barrett that I do not agree with Mr. Krugman's assumptions. This country has come through an extraordinarily difficult period. As stated earlier, Ireland chose to follow a route of constructive engagement and negotiation and this has resulted in our being able to achieve changes of the order of €50 billion through changes in the terms of the promissory notes, interest rate reductions and approval to buy out €18 billion in loans borrowed at higher rates from the IMF. Said buy-out will save taxpayers €1.2 billion in interest charges over the period of those loans. It is through negotiation that changes such as those to which I refer are hammered out, agreed and approved. This means that the challenge accepted by the Irish people is now being vindicated and is evidenced by our being in a much stronger position, with confidence rising. I reiterate, however, that all of this is quite fragile. The programme for Government states that we must explore measures relating to debt sustainability. There has been an ongoing battle in this regard in the form of a series of consultations with the European institutions. Putting together a banking union, developing supervisory mechanisms, etc., form part of the negotiating process. Of course, the option of lodging a claim for direct recapitalisation, which has been on the table since June 2012, remains open to the Government if it considers this the appropriate and best course of action to take in the interests of Irish taxpayers. As the Deputy is aware, there are other options to be considered and evaluated.
Far from offering a muted response in respect of the debt issue, we have proven that the progress made to date has been in the interests of both our people and our country. Deputy Boyd Barrett was not present when I stated that I had already sent a message to the new Prime Minister of Greece wishing him and his Cabinet well. I hope the enormous challenge faced by the Greek people can be met. We were lectured by many individuals to the effect that we would not be able to change one iota of the troika programme, but that did not prove to be the case when the Government engaged in negotiations over many of the elements contained in the programme. The elements to which I refer remain extremely difficult for our people. That is why I have made the point that Ireland needs to hear the European Central Bank's side of the story. I hope the Joint Committee of Inquiry into the Banking Crisis will be able to capitalise on the progress made in this regard in order that the latter can actually happen.
These are extremely important issues. I would like to think that as the year progresses we will establish a budgetary committee in the Houses and that the parties in opposition will be able to debate - in open forum - the challenges the economy faces and set out their stalls in respect of the budget for 2016, which will be introduced next October. Such a committee would enable everybody to have access to the relevant statistics and allow people to outline their priorities and the choices they propose to make.
So the Taoiseach is up for a debate. Will he be appearing on Vincent Browne's television programme?
Those in opposition will find that outlining such priorities is not always as simple as it sounds.
Deputy Martin might not be appearing on Mr. Browne's programme.
They can lecture us from the opposition benches about what should be done. Did I not hear Deputy Adams saying last night that he would give back all of the water contributions, amounting to €3 million?
Will the Taoiseach go on Vincent Browne's programme for a debate?
Not at all. He is afraid.
Deputy Adams would want to get his figures right.
"Tonight with Vincent Browne" has been waiting four years for the Taoiseach to debate these issues. Is the Taoiseach providing confirmation that he intends to go on television to debate them?
That concludes Questions to the Taoiseach.
(Interruptions).
Written Answers follow Adjournment.