Dr. Matthew Sadlier:

There are a number of points to address. First, on the question of the ring-fencing of funds, the IMO has just published a paper on alcohol, hot off the presses, that we can distribute to the joint committee in which we call for a health levy on alcohol manufacturing to contribute to the health care costs of alcohol related harm. At numerous conferences, we have called for the ring-fencing of funds and it is an issue with which I agree. I must admit the issue regarding greyhounds and horses is not something of which I had heard personally before today. It certainly is something we will consider seeking to utilise. As for the funding of the health service, to address Senator Barrett's questions, the health service in the 1980s was significantly underfunded. Consequently, the fact that we are catching up with the rest of the world certainly is a good thing and we welcome the increase in posts. However, we still are below the OECD average with regard to the number of specialists per head of population. The population of the country has increased by approximately 1 million people since the last recession in the 1980s, which also would contribute. In addition, however, the age profile of the population and the complexities of medical care have changed astronomically from what they were in the 1980s to the present. People are surviving illnesses that previously would have been terminal and people who have survived serious illness, be it mental or physical, require ongoing long-term chronic care. That level of ongoing chronic care management probably was not available or seen in the 1980s.

To address the Vice Chairman's final comment, the IMO would support a number of aspirational concepts towards the provision of care. The issue is the devil really is in the detail and it is about the negotiation and the ability with which, as health care workers, we are being asked to provide a safe and high quality service. While that is what we want to do, we seek to be provided with the tools to be able to so do. We have position papers on universal health coverage and it certainly is our aspiration to have a universal health service. However, it is a matter of being able to be provided with the tools to be able to deliver that at a high level of patient safety and a high level of quality. As I stated, the devil is in the detail and in the negotiation around that.