John Crown (Independent) | Oireachtas source

On the specific questions I raised today, I do not believe the specific question about the gagging clause in the GP contract has been as yet addressed in the written answer I have been given nor has the onerous increase in the bureaucratic demands which will be made on GPs in the new under six GP contract.

Similarly, I would like to get a quick opinion as to why we do not have electronic record-keeping and telemetry in our ambulance service. It was piloted in the north east but, for some reason, that pilot was discontinued. The company which did it has taken that expertise, developed the software and is now doing it under contract on a routine basis in the United Arab Emirates. Would it not bring specific advantages to us here?

On the issue of hospital boards, the reply to my query about the ambiguous nature of our hospital boards is that at present, if I understand it correctly, these are separate independent entities which exist under a separate part of corporate governance with whom the HSE has service contracts. I would say to the Minister and Mr. O'Brien with respect that I think there is a world of difference between the kind of service contract the HSE may well have with some place like the Beacon Clinic to give a certain specific service, such as dialysis or some other service, or perhaps to contract something under the National Treatment Purchase Fund under service contracts to other private entities, to the situation that applies where a big public hospital, which effectively has monopoly status in the area where it does its business, is entirely funded by the health service. I do not believe we can basically exculpate them from having any answerability or responsibility to the HSE, the Department of Health and to the health service because they exist under some separate corporate structure with whom we have in theory a cancellable commercial relationship. We all know that is not the case. The Minister or Mr. O'Brien can no more tell St. Vincent's hospital or the Mater hospital tomorrow that they will no longer do business with them than it could completely "undefund" St. James's Hospital or Blanchardstown hospital.

This goes to the core of what happened. The chairman of the board of St. Vincent's hospital stated that it would consider appointing public interest directors to the board. In the name of God, if the current board is not acting in the public interest, in whose name is it acting? I think we all know in whose name it is acting, and it is not in the public good.

This unbelievable fiasco that is now occurring with the B contracts will be a loss for public patients when private patients are clogging up their waiting lists, a loss for private patients who will have decreased access to private hospitals and a loss for public hospitals which may well find it as an increased burden on them. It is great for people like me because I am on the old contract and will have fewer people competing with me, so do not think this is self-interesting talking. The only group which will benefit from this developing fiasco, which was brought down on the heads of the patients and doctors of St. Vincent's hospital by the actions of the board of the hospital, are the insurance companies which will make fewer payments.