Mr. Liam Doran:

The number of hours worked by NCHDs outside the average figure of 48 hours continues to grow. There are two reasons for this. I do not want to be misunderstood when I say this, but the numbers of NCHDs and medical staff have been maintained throughout the embargo period, which is wholly proper. However, the numbers of nurses and support staff have dropped. This has meant that the pressure has fallen more on NCHDs in the out-of-hours periods. I refer to the abject failure to redefine in a planned way the roles of nurse and health care assistant. If these roles were redefined, there would not be a need to call a doctor at 4 a.m. to perform a relatively simple task which the nurse should be empowered to do. The ward should be staffed appropriately to carry out such tasks. The problem on the other side is that there are no laws in place with regard to what should be the workload of staff. I do not wish to be alarmist, but as a citizen of Ireland, I genuinely and honestly say to the committee that I am fearful of where the health service is going in terms of its ability to look after me when I get sick, as the staff are being stretched. They do not have the time they need to perform procedures properly. They are documenting this, but it has been ignored or forced to be ignored by managers who do not have the money or the posts-----