James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank Senator Colm Burke for the issue he raised, as it is one of that is serious concern, and certainly of serious concern to me. The idea that people are on six-month contracts is something I have discussed already with the Department. We are looking at giving people a three-year contract when they have done their intern years. In that way we would have them for two more years as SHOs, and that would also give them some certainty. Equally, when people join the SPR scheme, it costs €150,000 to €200,000 to train a medical student - we have had this conversation previously - but it costs €1 million to create a consultant. If we are looking for value for money and trying to retain people, surely the people we need to hold onto are the people coming off the specialist registrar scheme. We should not be letting three out of four of them go because we have not organised our manpower issues in the manner in which we need to organise them. I want to knock something on the head here. One of the reasons for this situation is unaffordability, because of what we pay consultants. The contract for new entrants is €116,000 to €121,000 per annum. The starting pay for a consultant in the UK and the North of Ireland, which I discussed with the Northern Ireland Minister for Health, Social Services and Public Safety, Mr. Poots, who was down here for the eHealth conference last week - he and I travel up and down and talk quite frequently - is £80,000 sterling. Naturally, people like to compare what they can make in America and the wealthiest countries in the world, but let us consider other places. We are often accused, when talking about drug costs, of looking at a basket of countries whose prices are lower than those in the basket of countries we are in. The same applies here. I believe consultants should be paid well because they do an extremely important job, save people's lives and spend a long time training. I do not know of any other area in which the amount of training they undertake is done. They deserve to be rewarded for that and for the commitment they show to their patients. Without them and without the excellent people on the front line - our NCHDs, all our nursing staff and nursing officers - we would not have been able to maintain a safe service, and in fact to have improved it, in the past few years with the challenges we face.

In terms of the hospital groups and the European working time directive, we are committing to addressing that. The hospital groups are hugely important in allowing and enabling us to do that. Equally, some of the proposals made during the talks with the unions will perhaps allow for a lot of work being done by NCHDs to be done by nurses. There is an understanding that there can be a much greater and much more rewarding role for nurses.

Deputy Naughten raised the issue of medical cards, which the Minister of State, Deputy White, will address. I ask that Dr. Áine Carroll, who is here, have an opportunity to address the issue of strokes, raised by Deputy Naughten. Mr. Tony O'Brien can address the question about the national ambulance service.

The issue Senator Crown raised is one that is very close to my heart. I have declared war on the tobacco industry in the Seanad. I know of no other legal industry whose product causes one out of every two people who use it to die, and that is the reality. Some 700,000 Europeans die from tobacco-related illnesses every year, of whom 5,200 are Irish men and women. Was I aware of this meeting? I was. Would I go to it? No, I would not. I was trying to access a line in the directive on my iPhone, but what I remember from the directive is that it does not recommend that people meet with the tobacco industry except in the area of smuggling, and that was the purpose of that meeting.

I was in Geneva at the World Health Assembly for the WHO last week and I took the opportunity to talk about the tobacco control framework of the WHO and to talk to several other Ministers about the tobacco directive in Europe, of which I am strongly supportive. We have led the campaign in ensuring that this directive makes as much progress as possible. It is our highest priority. Clinical trials are also a high priority. It is an issue for Europe that we are losing funding for research, which is going to other jurisdictions because of the difficulty with bureaucracy that many people experience in Europe. I accept Senator Crown, who I know is involved in research, is up to speed in this area. There is much more we can do to improve this. I take the opportunity again, as I always do, to encourage people to become involved in clinical trials, because not only will they get access to cutting-edge medicine, they will also get a level of supervision they would not normally get as a matter of routine.

Senator Crown mentioned black ops in regard to HIQA. I am going to ignore that, but I will talk about black ops in a different way, and this might be news to some people here because the media do not seem to have taken up this story in a big way. There was a break-in at the EU offices in Brussels last year. The intruders abseiled down from the roof to the seventh floor of the building, cut holes in the plate-glass window, disabled the alarms and got into the offices. There were a number of offices and they went straight to the Office of Tobacco Control and removed all the hard discs from the computers. Who could afford to launch such an operation?