John Brassil (Kerry, Fianna Fail) | Oireachtas source

I thank the witnesses for coming in. I will cut to the chase as I am sure they are beaten down with questions at this stage. I was struck listening to Ms Cowan's presentation in particular when she said that single clinical governance across all areas was the key to providing operational expertise. That is the key to me also. I am not sure about the different groups. If we take recruitment for example, do any of the parties here recruit as a group? One has category 4, 3 and 2 hospitals. Graduates look for the category 4 hospital because that is where the most activity is going on and where they will learn the most. That is at the expense, however, of category 3 and 2 hospitals, which we need as much as we need category 4 hospitals. If a consultant, SHO or nurse is being recruited, he or she should be recruited for the group. The group should say to an applicant that he or she may be in Limerick or Ennis and the person can then go to wherever he or she is directed to go. That way, one will not get all the cream in one area and the rest left struggling. I do not know if that system operates in any of the groups. If not, it should. It would be a huge benefit. The situation in Kerry is the one with which I am most familiar and we will be dealing with it in the next session. There is one geriatric consultant in Kerry whereas there are 14 in Cork. It makes no sense that one or two of those cannot be seconded to Kerry on a six-monthly or 12-monthly basis to help out. It would provide great relief in the system if that was done.

I saw in the presentation the consideration of day surgeries in model 2 hospitals to relieve pressure so that an accident and emergency or trolley crisis does not mean having to cancel procedures. That is fantastic and a progressive way to maximise the use of model 2 hospitals and avoid impacts on model 4 hospitals. I would like to see that replicated. Perhaps the fact that only one CEO has to be dealt with is the reason it is possible to get all these things in place. It might be the model of best practice to which we should all aspire. I hope there is a capacity within groups to do these types of things. That is my next question. Is that capacity there? If a hospital group decided in the morning that it wanted to go along with recruitment suggestion I made, could it or would there be obstacles in the form of unions or people refusing and an absence of the power to make it happen?

Dr. Nash spoke about how the hospital group was put together and what it has being what it has. Is the make-up as it stands correct or are there discussions among the groups where they say that Tipperary should be in with one or another? I am not asking the witnesses to make suggestions on the spot, but they might come back to us with suggestions in written form because we need to know these things. If there are one or two hospitals that are outside the group within which it would be better for them to be, we should be told. If we can make it happen, we will. This is an opportunity. There is no point in saying, "We should have". We should be told now because the witnesses are in position and know the workings. If there are positive changes that could be made, we should by all means be told what they are.

Deputy Kelleher mentioned information technology and Mr. Power said there was currently no IT link between the hospitals in his group. How difficult is that to achieve given that it is critical? It would save so much time and effort and the technology to do it is certainly there. How do we make that happen? The witnesses should tell us and we will do our best to try to get it delivered.

A comment was made that morale was at an all-time low in UL. Certainly, I have not found that in my experience. I live not too far away and I feel the morale in the group is good. I have no difficulty in saying that.