Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

When consultants are doing private work they are not dealing with waiting lists. They are treating private patients who are not on waiting lists - unless the Government pays for public patients to go private, which has been done in the past.

Deputy Ó Caoláin made a number of very fair points. He said we needed more nurses, and I agree with him. We had 500 more nurses last year than the year before, so the numbers are starting to rise again after a very big reduction. There will be further nursing posts this year, some of which have recently been agreed at the Labour Relations Commission. We now have more consultants and midwives than ever before in the history of the State and fewer managers and administrators than at any time since the establishment of the HSE. This information does not come across very often, but it is true. The HSE service plan provides for more consultants and midwives.

We are having problems with recruitment. Just last week, we secured agreement with the IMO on new salary scales for consultants. Those positions will be advertised in batches over the next couple of weeks. It will take months to fill the positions, as the nature of consultant posts is that people need to move from somewhere else. I am confident that they will be filled, and this will help the situation.

Recruitment is far too slow with regard to other health professionals, such as in the field of mental health and nursing, because recruitment is processed through the national recruitment service in Manorhamilton. That system was set up at a different time when the drive was to reduce the headcount. Now we are trying to increase numbers and we need to turn the whole system around. There will be more local recruitment, allowing hospitals, once again, to do their own recruitment in certain circumstances.

A reference was made to a lack of ambition. I have published 25 detailed actions that we intend to undertake in 2015 alone. If we could complete 22 or 23, we would be doing extremely well. One can be very ambitious but not achieve anything. It is better to be realistic and be in a position to achieve something. I think if we can achieve 22 or 23 of those 25 actions it will be a good year's work. However, it will not solve all our problems.

The issue of drugs savings is being addressed in three ways. We are continuing reference pricing for generic drugs, where the Government sets the price and that is what we pay. These are usually the UK prices or a little above, and that will continue throughout the year. We expect tens of millions in savings from that policy. With regard to on-patent drugs, we are now in the mid-term review of the IPHA agreement. The basket cannot be renegotiated until the agreement is renegotiated at the end of this year. We have indicated to the industry that if a discount cannot be agreed we will use our legislative powers to impose a discount on those patent drugs. That can be done in a matter of weeks.