Oireachtas Joint and Select Committees

Wednesday, 14 September 2016

Select Committee on the Future of Healthcare

Future of Health Care (Resumed): Dr. Stephen Kinsella

9:00 am

Photo of Kate O'ConnellKate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I thank Dr. Kinsella for his presentation. My first question concerns the way our system is structured in Ireland. We have the regional health organisations and, on a separate wing, mental health and social care. Is that kind of division between acute care and social and metal care reflected in any of the other models Dr. Kinsella considered? It seems to me, from my position on this committee, that if mental health has its own wing, that immediately stigmatises it. Is that division present in any other country?

Dr. Kinsella mentioned something about pensions in the health service accounting for 25%, I think, of overall pensions. Maybe we do not know the reason for this, but is it to do with salary levels or the fact that nurses within the HSE are forced to retire at 65 even if they do not want to? Is it because we force people into retirement early?

To follow on from Deputy Brassil's point about where we are now and whether we have done anything yet to fix things, does the same go for IT? Are we 50% of the way through the IT developments or are we just starting off?

We talk about workforce planning over a two-to-three-year period. That is great and must be done, and there is obviously time that one needs to spend planning things, but while that is being done, could a section of the health service be taken and sorted out in tandem with that so that we are not just coming up with another plan or report - so that we could actually achieve something? For example, everyone seems to agree that the national cancer strategy was a major achievement and everyone says it seems to work very well. My experience of it has been very positive. The national maternity strategy is ready to go. Maternity hospitals are separate from general medical hospitals. Could one theoretically carry out that strategy in tandem with a kind of overlook of the whole health service? Instead of this "Let's fix the health service" approach, could we set about planning for it over a number of years while fixing little sections of it as we go along?

Finally, doctors, pharmacists, physiotherapists and occupational therapists from Ireland have moved to other countries and there is a fair amount of skills transfer. As a nurse, one can go to Australia or whatever. Do we have any data on, or are there any optimum ratios of staff that we could take from other countries? Would it be possible to say that on average, internationally, for every ten consultants one needs 30 nurses, three pharmacists, two phlebotomists and five care assistants, or whatever? Is there some point at which we could start that we could use as a standard for what we might work towards?

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