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

I thank the Chairman for that. Make no mistake, it is a battle. There are vested interests who are very happy with the status quo, on which I will make a broader statement. I do not accept the status quo in our health service and in our health training because it has not delivered for patients and it is not delivering for our doctors or nurses. We need to give them a fair and reasonable life so that they are better positioned to give us the excellence in care which they have been trained to give and which they want to give but which they are frustrated in giving.

There was a question about the fair deal scheme and I will defer to the Minister of State, Deputy Kathleen Lynch, on that.

All I will say is that a huge number of people have been accommodated on that scheme. We are currently reviewing the nursing homes support scheme and are very much focused on trying to provide more care at home and in the community. We are acutely aware of the fact that when one has a large fund of money, amounting to almost €1 billion, everyone tends to head in that direction. In some parts of the country people are ending up in long-term care way before they need to be, while in other parts of the country people cannot get such care even though they desperately need it. We have a single assessment tool about which I have advised the committee previously and that will help us to take a more uniform approach to assessing the needs of older people and determining how they can be best met.

Deputy Mitchell O'Connor raised the issue of non-consultant hospital doctors and the EU working time directive and I repeat what I have said previously on this matter. I believe it is wrong and unsafe to ask young doctors to make life or death decisions when they have been on their feet for 36 hours. It is wrong and there is no defending it. We will address it and will do so in a very short, sharp exercise. I hope that those who have become rather comfortable with the situation will realise how wrong the current practice is and become very uncomfortable very quickly. I am pledging to this committee that I intend to make them very uncomfortable.

The issues of defibrillation, childhood obesity, symphysiotomy and stroke were also raised. Dr. Áine Carroll is here and can talk to the committee about rehabilitation, stroke and how it is managed. I would point out that there has been a phenomenal improvement in the care of stroke victims in this country in the last 18 months. I wish to thank those involved in the clinical programme for this because the improvement has been astonishing. We have gone from the bottom of the ladder in Europe in terms of thrombolysis - the use of an agent to dissolve the clot that causes many strokes - to the very top in only 18 months. Dr. Carroll will confirm the improved statistics on the number of lives being saved and the numbers of people avoiding long-term as a consequence of stroke.

I am very concerned about the issue of childhood obesity. This is the first Government to put in place a principal officer across the Departments of Health, Education and Skills and Children and Youth Affairs to deal with this issue. Regarding the issue of symphysiotomy, this was a wrong that was done to women. It is yet another one of the legacy issues that have been left to us by a series of previous governments but is one we intend to address. The Government instructed me on Tuesday last to speak to the women concerned in order to plot a pathway forward so that we can bring some closure to this issue for them. I also met the women who were victims of Dr. Neary, who had inappropriate medical procedures carried out on them and who were excluded from the redress scheme solely on the basis of age, which was utterly arbitrary and wrong. I am very pleased to announce that we had a very good meeting and have put in place a scheme to try to bring closure for them. I know we cannot undo the harm that was done to them but we can, at least, start the healing. I will now hand over to the Minister of State, Deputy Kathleen Lynch.