Mr. Liam Doran:

Not if "resources" refers only to staff. There are major issues relating to areas such as bed capacity, step-down facilities and primary care. The problem in Limerick was exacerbated by the reform programme that remodelled facilities in Ennis and Nenagh without educating the public on how to use them. Due to this members of the public are still filtered to Limerick although their minor injuries and so on could be dealt with in Ennis or Nenagh. The preparatory work was not done. The reconfiguration was done in haste and patients are repenting, though not at their leisure.

A good point was made on nurse staffing and the irony of the situation in which we find ourselves. I will raise a compare and contrast scenario for the committee. On the Friday of our recent annual conference the Secretary General of the Department of Health attended on behalf of the Minister for Health because he was ill. He announced that the Department is to establish a workforce on nurse staffing. This is to be the first step in the collective agreement to stabilise the nursing workforce and is to be in tandem with the military workforce forum that was established after the Portlaoise tragedies to stabilise the military workforce.

We had that announcement on a Friday about nurse staffing, and we had the midwifery workforce up and running. The following Tuesday, the HSE produced this plan to replace nurses with interns and community nurses with new graduates, or else to downsize nurse management structures and care of the elderly. The organisation is therefore fully entitled to make the point to the committee - and the newly appointed chief nursing officer has stressed it, too - that we had the potential to arrive at a stabilised nursing workforce underpinned by best evidence and correct utilisation of the nurse-patient ratios. We had a 12-month timeframe in which to do it and were all committed to it, and then, four days later, the HSE announced its plan, which had no engagement, uses no known dependency tools and rips up everything that currently exists. That is what we find frustrating.