Colm Burke (Fine Gael) | Oireachtas source

I thank the Minister for a very comprehensive overview. I wish to raise a couple of points on the issues he has discussed. The first point is about the cost of drugs. I want to know what the actual total cost is. The Minister mentioned a figure of €1.9 billion in reimbursement and another €300 million in relation to the hospitals. That brings us to €2.2 billion. I presume there is another €300 million or €400 million on top of that which we are technically paying out on pharmaceuticals. Does the Minister feel that we could be doing a lot more in order to reduce that overall bill? We have one of the highest expenditure levels per capitaon drugs and pharmaceuticals compared to other EU countries.

The second issue relates to waiting lists. I receive a lot of complaints from medical consultants in the HSE who have their own contracts but want to do more work. They cannot get the beds and cannot get operating time in theatres. If they were allowed to work in other facilities without affecting the hours they put into the HSE, a number of people could be taken off the waiting list. I heard recently of six patients in a public hospital who were referred to a private hospital for hip operations and the HSE picked up the tab, which was €10,000 for each patient. Four of the patients had private health insurance cover but the money was not claimed from the insurer because they were on a waiting list in a public hospital. Should we not look again at the fact that we cannot give experts the beds or the facilities but other facilities are available to them to carry out operations?

Since 2009 a lot of cuts have been made affecting junior doctors, such as in education grants. A huge proportion of junior doctors are not Irish graduates and all Dublin hospitals have problems getting junior doctors. Is this issue under review for 2016 and 2017? It is a crucial issue that we are losing a huge number of very good people. I am not talking about increasing salary but about restoring some of the grants which were removed from them in the past five or six years.