John Crown (Independent) | Oireachtas source

Go raibh maith agat, a Leas-Chathaoirligh. I warmly welcome the Minister to the House. He has been one of the stand-out performers of the current Government. His intervention in an unrelated issue, with respect to the Garda whistleblowers, was one of the single most inspired political interventions I have seen in modern Irish politics. It certainly had great impact and was critically important for which he deserves great commendation.

I welcome his new appointment. It is an opportunity for him, at this particular juncture in the history of the health service, to kick-start a necessary reform process. That can be achieved in a much shorter timeframe than is widely accepted if he applies vision and energy but I shall let him off for the summer. After he returns from walking the Camino we will expect to hit the beach running in terms of the reform process.

I want to focus on one very small but critically important part of blindness and vision handicap, a factor which will become much more important due to an ageing population and, sadly, the increasing problem of diabetes and grappling more with weight issues. I refer to staffing levels which is a hobby horse of mine and I will sound like a broken record due to mentioning it so much over the remaining term of the current Oireachtas.

At the core of the dysfunction of the health service is a bizarre career structure for doctors and a bizarrely small number of career level doctors in two specialties, namely, family practice and hospital-based specialties. Ireland would be the laughing stock of the world if it were not for the existence of the United Kingdom. The fact that the United Kingdom's health service is nearly as bad as ours somehow acts as a buffer zone in terms of international comparison. A few weeks ago distinguished visitors from the ophthalmic professional community and advocacy community attended the health committee. At the time I was lucky to have an opportunity to get some numerical information from them which stated that Ireland has one ophthalmologist per 110,000 of population while Scotland has one ophthalmologist per 70,000.

In general, United Kingdom figures for any specialty tend to be approximately one third or one quarter of continental European figures which, in turn, tend to be approximately one half of North American figures. I imagine the Minister will get the gist. Germany, Greece and France have approximately one ophthalmologist for every 25,000 citizens while we have one for every 110,000 citizens. If we factor in the existence of community and medical ophthalmologists, the figure comes down a little but it is still greater than the Scottish figure and compares desperately unfavourably.

The Minister will find himself at a unique vantage point as he attempts to reform the health service. He will see in front of him people who he is trying to persuade and behind him people who really should be on his side in trying to forge reform. He will have to look backwards sometimes and realise that the impetus for reform must come from those who are in officialdom as well as those on the front line of services. The Minister will hear different visions of the future. I do not like disagreeing with Senator Burke too often because I regard him and Senator Barrett as the two finest legislators in this House as well as two of the more thoughtful scrutineers of the legislation that comes through. He is not always the most attentive when I am speaking.

Anyway, the record should reflect the fact that the thing which changed cancer care in this country was not that the country with only four oncologists put together a series of bureaucracies that fixed the problem. Rather, it was when the then Minister, Deputy Michael Noonan, stood up on his first day in the current Minister's office and, with a little gentle plagiarism of something I said - for which he has my full permission - stated that there were hospitals in the country to which he would not let a relative of his with cancer go and that the key issue was appointing enough cancer specialists. Cancer mortality rates in the country improved because we went from having four to 35 oncologists. For the duration of my career and beyond I will believe that the success was not because we appointed new national co-ordinating bureaucracies.

In addressing the deficiencies of the ophthalmic services I call on the Minister to keep a laser-like focus on the issue. We have a bizarrely small number of specialists. As with other areas this will need to be addressed if we are to bring ourselves up to international standards and I believe the Minister has a great opportunity to do this.

I will not say much more. I take this opportunity to welcome the Minister in his new role, to wish him all the best and to assure him that he will have 100% co-operation from me in any way possible to try to advance the reform of the health service in any way we can.