Séamus Healy (Tipperary South, Workers and Unemployed Action Group) | Oireachtas source

I welcome the Minister and his officials, and Mr. O’Brien and the officials from the HSE. In particular, I welcome the Minister’s emphasis on the Public Health (Standardised Packaging of Tobacco) Bill. This is a fundamental issue for public health and for the health service. The committee has set aside several weeks from next Thursday until 13 February to deal with submissions on this. I look forward to the Bill's speedy progress through the Oireachtas.

On Tuesday, I asked the Minister for clarification on the appointment of the boards of the hospital groups. I understood him to say that the appointments were imminent. While he refers to the groups in his opening statement, he does not refer to the appointment of the board members, apart from the chairperson and chief executive officer. Is that imminent and, if so, how soon will it happen?

There are particular pressures on the health service in certain locations. The national service plan acknowledges that and it sets aside €30 million for additional capacity in areas within the acute services which are experiencing increased demand, such as emergency departments, inpatient day care and outpatient department, OPD, services. Some hospitals appear consistently to have trolleys in emergency departments. One of these is South Tipperary General Hospital. It is a very modern, progressive hospital where staff and management work together as a team, and with regional HSE staff, attempting to solve this problem. As the service plan acknowledges, there are particular pressures in some areas and this is one. The budget for that hospital has been reduced by approximately one quarter over the past few years. It has lost a considerable number of staff. Remaining staff have made a huge effort, working above and beyond the call of duty, and additional activity and throughput has been gained. Will some of the €30 million that has been set aside be designated for South Tipperary General Hospital to relieve the pressure on its emergency department?

On Tuesday, I also asked Mr. O’Brien about the €56.5 million and €7.5 million for general hospital savings and reconfiguration of services. He explained that this referred to back office services and general day to day expenditure. He also suggested that a review is forthcoming this year regarding reconfiguration of services generally. Will he clarify and expand on that statement?

Do we have the figures for agency costs? I am told that the agency cost of a non-consultant hospital doctor, NCHD, can be a multiple of the cost of a directly employed NCHD. That has serious implications for budgets within hospitals. It also has implications for the recruitment of non-consultant hospital doctors. There is €1.3 million in the plan to deal with a sustainable approach to recruitment of NCHDs. What are the agency costs and what is earmarked to receive the €1.3 million?

My view and that of the public in general that there has been no change in the policy on access to discretionary medical cards is completely at variance with both the views of the Minister and of Mr. O'Brien. That is a situation which neither I nor the public accepts. It is quite obvious to me and to many Members on both sides of the House that there has been a significant change in policy in this area. We see it every day in our clinics. I had a call before I came to the meeting this morning about the very issue.