Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

No one here doubts the witnesses' competence or good intent. This, however, is a space and place where I do not want to have to address this issue again. I hope that at least we are on the one page in that respect.

Mr. Condon talks about a snapshot in time. The numbers he instanced were of 60 out of 90 positions in Letterkenny, and he stated that as of today the number is eight. Is this an ever-decreasing situation and the snapshot tomorrow will not have eight, 18 or some other figure?

Is it at least an underlying certainty that this is the case? Dr. Browne and Mr. Condon and, I believe, Mr. O'Brien and Professor McGovern stated we have been here before. This returns us to the point that we do not want to be here again. We must face the reality that this is a ramshackle system in which a flawed approach is taken to dealing with highly skilled and qualified young and not-so-young doctors. We must do much better, not only for the sake of the doctors in question but for the sake of all of those who depend on their skills. We must get to a better place.

Two years ago, we had to introduce emergency legislation to deal with a crisis. While I acknowledge that the crisis currently presenting is not of the same intensity as the previous one, there is a crisis at a number of a sites. This is reflected to me on a continuous basis. That we have been here previously and the services survived does not give me any comfort. As a Dáil Deputy who covers many issues, health being a large portfolio as a shadow spokesperson, it is a matter of serious concern that it is being flagged to me and colleagues of all political views that we are facing crises where services will not be maintained.

When we seek the opportunity to engage with the Health Service Executive and others, the purpose is to try to find solutions, help and encourage and use our positions to complement efforts being made to arrive at a better place where the likes of this will not take place again. Professor McGovern used the expression, "If we were able to envisage". The joint committee has made recommendations and identified, as our guests acknowledged in their responses, what needs to be done. We must eliminate the dependency on non-consultant hospital doctors who one of our colleagues in this committee refers to in less than glowing terms, making reference to apprentice mechanics. My life depended on a non-consultant hospital doctor during a cardiac event seven years ago and I would have the same trust in presenting if the situation were to take place again. However, we need more consultant physicians and we must reach the position where trainee opportunities are available across the board and doctors have a career path and certainty and are encouraged to remain in the service, especially given the high cost of training from college level onwards.

While we are most certainly able to envisage, we are no longer willing to envisage a repeat of the previous circumstances. I am at the end of my tether on this issue. The answers I have given to those who have made inquiries to me about the five-page report at the quarterly meeting was that it was not worth a ball of blue. I sought further detail, for example, on whether the position regarding anaesthesia and South Africa, respectively, still obtained. With respect to Mr. O'Brien, while I know he is making every effort, I can only take from what he has shared with us that the position remains as it was and we do not have certainty of a full complement across the board, which would erase the concerns of front-line service providers. They are the voices behind my seat and every other seat at this table and they are justifiably unhappy with the current position. We need to be absolutely certain that we are approaching the end of what I just described as a ramshackle approach to the provision of trained doctors in our hospital system. Currently, the system is not fit for purpose and we are going from crisis to crisis every six months. The position is intolerable and cannot be a happy space for those before us who have responsibility for addressing it.