Gino Kenny Demands Evidence of 'Resistance' to Sláintecare

Thanks for all our witnesses today. Minister and Mr Watt, I think everybody will agree that the last number of weeks have been pretty bad for the concept of universal health care, i.e. Shlanta care, and whether that is internal or external factors, members of the advisory committee have asked some very serious questions of the future of Shlanta care. And given all that, and the perception that has raised, many people, or some people, which depends on how your objectivity goes into this, many people will believe there is institutionalised resistance to reform, whether that is the political, the HSC, Department of Health, or other bodies. Now, given the kind of some of the wording in relation to the resonations of Professor McCarty, Tom Kean, and Lauren McGathey, I mean, it is quite damning of the Shlanta care process, and some people, as I said, will come to perception that there is institutionalised resistance. Would you like to comment on that perception? Mr Watt, who are you putting the question to, Deputy? Mr Watt, both. Mr Watt, okay. Mr Watt, I will come on first. Mr Watt, yeah, sure. Mr Watt, thanks, Deputy, for the question. So, what I would say is that people who are saying to me there is institutional resistance, I am very available to talk to anybody, and for them to come to me with two things. First of all, to tell me what issue is the Department resisting, okay, so what policy issue, what aspect of Shlanta care are people saying that we are resistant to, first of all? And secondly, who is resisting? Is it me? Is it Paul Reid? Is it somebody else? So, making general comments, and I am not accusing you now, Deputy, of this, because you are reflecting on what people are saying, so I am not accusing you of this. But to make a general comment that there is resistance in an organisation to change or reform in the generality, it is just too easy, because it is just an easy comment. And, you know, it is a little bit of the whole people who watch too many versions of Yes Minister, you know, of these civil servants going around and not willing to make any changes and looking after their interests. It is a little bit 40 years old, to say the least. So, if people have any evidence, and people on the radio are saying this, I do not listen to the radio, but I have been told, people went out and said there was resistance, not only resistance, but brutal resistance, which apparently is an even greater form of resistance than normal resistance, brutal resistance, apparently. If people have evidence of that brutal resistance or resistance, they need to tell me that they can email me, text me, they can even organise a meeting, and I will listen to their evidence of what specific issue to which they are referring, and which officer. Like, is Bob here resisting the change, maybe Bob is, let me know, I don't know, is somebody else resisting the change, so who, who, rather than pretending that there are some vast conspiracy, shadowy figures, like it is all nonsense, if people have evidence, let them come to me and I will talk to them about it. Okay. Can I just paraphrase one sentence from Professor Gerald Ian McCarthy's resignation letter, right? She says at the end, however, in recent information, and my own experience, telling me we're no nearer to the required reform than we were six years ago. Now, I don't think that's fabricated. That is coming from somebody that has been, you know, spearheading the concept of slantacare. So, you know, this has to be taken very, very serious if a person that's, you know, leading the charge in relation to slantacare is actually saying this. We have to take any such resignations very seriously. Laura McGahee is a serious person. Tom Keane is a serious person. I take their resignations very seriously. In fact, you will have seen very substantial new proposals from me, along with the Department of the HSE, in terms of governance of this. I am appointing the Secretary-General of the Department and the Chief Executive of HSE now to this, right? That's the level of senior leadership that we'll have. That board will report directly to me, and I will report directly to Cabinet. Now, I think you quite rightly say that there has been damage done. I think that's true, and there is a perception amongst some that change is not happening. We have heard a member of the committee already today say that the Department is incapable of change, and the HSE is incapable of change. And all I would say is that we, as parliamentarians, need to be very clear as to the evidence, right? Is there resistance to change? In my experience, people don't resist change, they resist loss. And so if people in any walk of life, in any organisation, the HSE, the Oireachtas, Microsoft, whatever you want, in any organisation, people will resist perceived loss. And it's why we have to get the reorganisation right. Because if it is perceived as something whereby people lose out, they will resist that change. It's human nature. We all resist loss. And it's why it's so important that the reorganisation is done right. Doing a reorganisation of a healthcare system is a bit like trying to upgrade a Boeing 747 in mid-flight. We don't get to shut down the operating theatres. We don't get to tell the doctors to go home and the nurses to go home for two weeks. We don't get to shut the maternity hospitals. Everything has to keep running. All of the patients have to be seen. No machine gets turned off. Nobody gets to go home. And while they're still doing their jobs under immense pressure, we have to rewire the system in an important way. And that only works when the system itself and the men and women that work in that system are bought into the change. And so the point I was trying to make earlier was when any of us make statements about there is no change. There is no progress. These people, whoever these people are, are incapable of reform. It is incumbent upon us as parliamentarians to look at the evidence. And the evidence we have, I would say to the committee, is unambiguous. The Sláinte Care office itself handed me a progress report saying 97%, think about this, not 60% or 70%, that 97% of our projects were on track or on track with minor issues. Now, I don't understand how an organisation can be 97% on track and at the same time incapable of reform. And I would also, and I think we would all agree with this, Deputy, I spend a lot of time out in the healthcare system talking to our frontline workers. And I think I would speak for us all when I say what they have done over the last 18 months. And they are passionate about the people who they serve. The Department of Health, be it in the HSE or be it our frontline workers, is people who are passionate about universal healthcare, who have probably implemented more change over the last 18 months than any organisation any of us could see. Is it perfect? No. Does everything work perfectly the way we want it to work? No. Will you get pockets of resistance to certain ideas? Absolutely you will, as you will get anywhere. But ultimately, is this a system that wants to reform, that is capable of reform and that we in government are deadly, deadly serious about reforming to ensure universal healthcare 100%? Thanks. Thanks. Mr. I don't disbelieve that, you know, given all your statement today, that there is change. Nobody kind of listening to today's events and previous events will doubt there is change. Now, how fast that's going, that's up for question. We all want universal healthcare. We want a system where, you know, a system that kind of ends the two-tier health system. Just in regards to private healthcare and public hospitals, which is one of the concepts of change in slanticaire, what is the current position of reform in regards to private healthcare in public hospitals? Because for most people, that's kind of counterintuitive to universal healthcare. And is there resistance from private medicine to decoupling that in our public hospitals? Because I think, as I said, most people listening to that concept of private healthcare and public hospitals literally would say, well, look, if you don't start with that, then we have a problem. Mr. Thank you. Mr. Thank you. Mr. Thank you. Mr. Thank you, Deputy. Mr. Thank you, Deputy. Mr. Removing private care from our public hospitals is absolutely essential. It's essential. And we are in the middle of negotiations with regard to a public-only contract. And I can't get into the detail on that, obviously, because the negotiations are ongoing. But the policy goal is public patients are treated in public hospitals, and that's it. It's very important. And then to your question on resistance, I would just say again, Deputy, the doctors in our system have dedicated their lives to their patients. What they want to be able to do is treat as many people as possible, as quickly as possible, with the best available technology and medical science. That's what motivates them. That's why they went to medical school. That's why they work 60, 70, 80 hours a week. And so what we need to make sure is that the change is positive and that it works. And move forward together. Mr. Robert, do you want to comment? Robert R. Thanks, Deputy. Just to add to what the Minister said, I absolutely agree with the proposal that we need to remove our private practice from public hospitals. I just do not believe the current system works. It leads to elements of dysfunctionality and it needs to end. And it has been heartening to hear so many consultants over the last few weeks, given their vocal support for Sláinte Care and saying that we shouldn't cherry-pick Sláinte Care. So that means that those consultants are obviously in favour also then of removing private practice from public hospitals, given their very clear support for Sláinte Care and all its manifestations. So, given those comments, we look forward to reaching agreement on making the changes that we need to do. Thank you. Mr. Robert R. Do you believe there is a timeframe? Is there a timeframe particularly for that concept of removing private healthcare from public healthcare? Mr. Robert R. There are negotiations going on now with the consultant body, so it is not appropriate, Deputy, for us to comment on that, but there is a timeframe for the end of this month to conclude those negotiations. The contract and aspects of that will be an important element of the reform to ensure that all patients in public hospitals are treated on the basis of need, not their insurance status. So, by the end of the month, hopefully we will have an agreement for a roadmap to move forward on this. That is one aspect of it. There are other parts of it, but that is a very important aspect. Mr. Robert R. Thank you very much Mr.