Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Where we want to get to with activity based funding is exactly as the Chairman outlined in terms of what we, namely, patients, citizens and taxpayers, are getting for the payment for that activity. This must also take outcomes into consideration, which means not only whether a procedure was carried out but how the procedure in question went. I must be honest and stated we are some distance from achieving this in terms of the development of the metrics required. This is, however, the journey we want to take.

Regarding integration of services, I know the Chairman is familiar with this issue as he briefed me previously on the success of a number of general practices in networking and using technology. An example is where a general practitioner is able to send an electronic record when he or she is on holidays. The primary care setting, specifically general practice, has been significantly ahead of the acute hospital setting in this area. We need to advance this process and the holding of health records in the cloud will be the key. I add the caveat, however, that data security issues arise in this context because health records will be privately held and made accessible to various medical stakeholders.

On local integrated care committees, I will visit the hospital in Kilkenny on Saturday. I hope to have an opportunity to meet the primary care group I am hearing so much about when I attend the Irish College of General Practitioners study day in two weeks. This group is an example of best practice and I am aware of a somewhat similar model in place near my home town in Wicklow where general practitioners are interacting with St. Colmcille's Hospital in Loughlinstown in a manner that is working very well. The Chairman's comments made sense but I will obviously await the outcome of the Committee on the Future of Healthcare's deliberations on structure. I am aware the Chairman is a member of the committee. We are promoting local integrated care committees nationwide. Dr. Fawsitt has provided great leadership in this area and is promoting the further development of LICCs on behalf of the Health Service Executive.

On recruitment and retention, the Chairman is correct that hospitals operate as centres of excellence and engage in best practice, they will increasingly attract people to work in them. The hospital groups will also help in this regard if we are able to recruit people on the basis of the hospital group rather than the individual hospital. Each group includes a range of hospitals offering various services and we will need professionals to move between hospitals in the group. I will not get into the business of naming hospitals but people will be more likely to gravitate towards a job in a flagship hospital, for example, one which is linked to a university. We are now recognising that the university and group are all linked rather than the individual hospital. This creates a different and perhaps enhanced environment. The Chairman is correct, however, that recruitment and retention are still major challenges for all health services, not only the Irish health service. We are moving into an era of reinvestment in health and providing a degree of certainty in terms of the direction in which we are moving. We are advancing the recommendations of the MacCraith report, reviewing GP training place numbers and the GP contract and ensuring nursing graduates are offered jobs. If we can sustain the current level of progress for a period, it will put us in a better place.