Colm Burke (Fine Gael) | Oireachtas source

I thank Dr. Fitzpatrick for his presentation. I also thank him for his long years of service in the obstetrics and gynaecological area and as master of the Coombe. I know that the hospital was run very efficiently and in a good manner.

Dr. Fitzpatrick has raised a few issues, in particular an issue that I have raised at all of the presentations we have had here and I refer to the Hanly report of 2003. In terms of the recommendation, at the time we had 93 consultants. I understand we now have 114 wholetime equivalents while there are 133 consultants on the books. What happened between 2003 and 2010 because no progress was made? Where did things stall during that period in terms of the change that has been clearly identified? I ask Dr. Fitzpatrick to outline how the birthrate changed in 2003. The figure rose to 75,000 births but I am not sure in what we year we reached that figure. Why did the health care system not respond to growing demand?

We have focused on maternity services here. It was highlighted by one of the people who made a presentation here last week that the issue is not just maternity services but also gynaecological services. In the overall discussion we seem to have lost sight of the fact that a range of services are provided.

We have not been given the numbers being dealt with in the gynaecologist services where the same people are working in both areas. It would be interesting to know the figures Dr. Fitzpatrick is talking about in regard to surgical procedures and all the rest of what is being done in that area.

On the employment of consultants, Dr. Fitzpatrick might advise the current ratio of the number of deliveries per consultant in the Coombe hospital. I am referring to whole-time equivalents. How does that compare to the ratio that would be the normal requirement in, say, an equivalent health service in the UK?

The second issue I wish to raise relates to agency staff and the availability of junior doctors and nurses. Does Dr. Fitzpatrick have figures for the number of doctors employed on an agency basis in the Dublin hospitals? How would he address that issue to make it attractive for people to work within the HSE contract system?

I understand the issues are not related to salary but to the conditions and issues such as training and funding for training. Dr. Fitzpatrick might touch on a number of the issues that make that system unattractive. I recently spoke to a UCC graduate who did an intern year in Ireland and is now working in Perth in Australia. I understand a core of students from UCC who graduated in 2014 are now all working in Perth. What do we need to do to reverse that trend in the context of the hospital systems in Ireland and, in particular, in regard to maternity services? If Dr. Fitzpatrick was in charge of that area in the morning what three or four elements he would change to make that difference? People want to go abroad to get experience, and rightly so, but people seem to be leaving. I conducted my own survey in 2012 of those who graduated in 2012 and it clearly identified that more than 60% of them had decided, even before they had graduated, that they would leave the country once they had completed their intern year. What changes would Dr. Fitzpatrick bring about in that respect?

In fairness to all the Dublin hospitals, they are not confined to looking after patients in the Dublin or the Portlaoise area but take in patients from other parts of the country where necessary. Dr. Fitzpatrick might indicate the numbers who are referred to those hospitals from throughout the country. What percentages do they make up? Are they a very small percentage? The three Dublin hospitals and Cork University Hospital provide very specialised services where genuine problems arise. What number of patients are referred to those hospitals from outside their immediate catchment areas? I thank Dr. Fitzpatrick again for his contribution.