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

I will begin by responding to Senator Colm Burke. He notes the full report will not be ready until June and is somewhat disappointed. I must respectfully say to him that this is the first time this has been done. It has been a running sore for 30-odd years. There has been an initial report in order that some changes can take place but to do the full job on this, particularly in respect of creating the clear career path, we must engage with quite a number of groups, including the colleges and universities. I do not accept that it should take 12 years to become a consultant and in other jurisdictions, it takes six years. I do not suggest that at six years, one will have the same experience as someone who has been a consultant for ten years, clearly not, but people need to be able to live their lives with some view of the future. I have asked that consideration be given to two and three-year contracts. This is a matter that will be addressed in the report as well, namely, the entire issue of retention and I believe a good report will be forthcoming from Professor Brian MacCraith. He is a good individual, who has an interest in this area and who is the president of DCU, one of the most progressive universities in the country. I attended a conferring ceremony there recently and noted that one of its alumni now is a worldwide assistant chief executive officer of Microsoft. Good people are produced from that university and he is a highly progressive individual. He perceives the need, as does everyone present, to give people a proper shot at life. If one is obliged to change job every six months, how can one have a marriage or a relationship? How can one even get a mortgage or a car loan, if one cannot show that one will have a steady income? All these issues must be addressed. It is complex and will take time but I believe it will be worth the time spent. There was one other issue that related to page 11, to which I will revert. The Senator noted the reply "it is not anticipated that the number of NCHDs holding six-month contracts would reduce in the short term". As I stated, I do not accept that either. I accept that it will change in the short term, I want it to do so and like the Senator, I would be concerned if this were to remain the case.

On the section 39 payments, I will allow the representatives of the HSE deal with it because there are technical issues in that regard. However, this all arose from the Tallaght hospital report from HIQA, which has uncovered quite a lot of irregularities in the system. In the very first public utterance I made on this issue, I made it clear that it would be open to people to come and make business cases for those situations which pertain. However, they must all be approved by the Departments of Health and Public Expenditure and Reform. That is the key and I reiterate we need transparency across the entire system. I will let the HSE deal with that issue.

Senator van Turnhout mentioned child and adolescent mental health services, CAMHS, and I will allow the Minister of State, Deputy Kathleen Lynch, to deal with that matter. In respect of cardiac rehabilitation and neuro-rehabilitation, we are highly fortunate to have in attendance the clinical director, Dr. Áine Carroll, and she can address that. The Senator also spoke about nurse prescribers. While I will allow the HSE to talk about that too, personally I am highly supportive of this and of a greatly expanded role for nurses, particularly in general practice but right across the system. I am pleased that with the roll-out of the colon cancer screening, advanced nurse practitioners will be carrying out the endoscopies, not consultants. We need to think outside the box in respect of how we use the staff we have.