Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

It is a given that co-operation in health can deliver real benefits and efficiency in the system. Everybody accepts there is goodwill towards the project and no one seems to be opposed to it. There is an argument that it is not delivering the results as quickly as we would like. I would like to concentrate on what Mr. McDonnell refers to as people guarding their patches. If there are difficulties in respect of the system, is there a way of better co-ordinating it? Under the current system, the Ministers meet and the officials meet. Can another layer be established or is there a need for a conference bringing people from medical backgrounds together with those who are concerned with patients' rights? They could look at the gaps in services and what we could do better. Has that ever been done? Would that be a helpful way of moving forward?

Yesterday, a group based in Maynooth, AIRO, made a presentation on its work to map needs and services throughout the island, particularly along the Border. The group focused on the limited number of services and time critical issues such as travel times for accident and emergency cases, coronary care and strokes. Co-operation on these matters is a real benefit for communities. One of the questions is whether the Department works with groups like this to map services along the Border. Does the Department provide support to map services and plan for cross-Border services in accident and emergency, coronary and strokes? We are familiar with the golden hour. How does this operate in respect of choosing between going to Louth hospital or Newry? What co-ordination exists?

Mr. Barron referred to the directive that is to be introduced. Is there anything we can do in respect of the resources? What is needed to speed it up? It makes sense in respect of cross-Border services. Is there something the committee can do if there is a delay?

The witnesses referred to what is available to people, including the E111 card. Is there a difference between jurisdictions? If I travel across the North and I am involved in an accident, I may be provided with services. Is there a difference if a similar thing happens to me in Spain or France? As an example, someone was recently involved in a serious accident in Spain. The person has been sent a bill for €8,000 because the person did not produce the E111 card. The person had it on a mobile telephone but this was not acceptable. The card has to be produced. Are there anomalies in the system that must be ironed out? We can talk about it later.

The witnesses also gave the example of people looking for care outside the jurisdiction. What are the options for people waiting for access to a paying doctor for one and a half years while on all sorts of medication that is making their condition worse? Rather than waiting for a year or a year and a half to see an ophthalmologist in Tallaght hospital, can I opt for this? What is the deadline?

Regarding specialties, do difficulties exist if Crumlin hospital or Newry hospital must upgrade services? If there is a lack of service in respect of certain specialties, what can we do? I am thinking about this committee and trying to encourage the cross-Border element. The witnesses must come back to us with recommendations that we can put forward to change the system. We are not looking for negativity for the sake of it but an improvement to services. That is what we are all looking for.