Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I thank Mr. O'Brien and Mr. Woods for their attendance and presentation. Mr. O'Brien made many references to the trend that we are moving more towards emergency and away from elective procedures.

My position is that the HSE is not serious about tackling this. I see no evidence of a systematic plan to deal with the issue. From the response to a parliamentary question I tabled recently, we learned that, from 1 January to 16 November, Tullamore hospital instigated the full-capacity protocol 511 times. That is a phenomenal figure. It suggests that the full-capacity protocol, which I understood was supposed to be a response to an emergency situation, is now becoming more or less a way of life. I agree that we are heading in the direction of more emergency and less elective care, but I put it to Mr. O'Brien that he is not in any way serious about dealing with that.

In responses to other parliamentary questions I asked, I learned that not one of the 14 primary care centres to be built is to get any additional staff. Everybody talks about the need to invest in primary care. Mr. O'Brien said that a significant resource will be required. How would he quantify a significant resource? What will it be? I am sure he knows. I am disappointed that he did not provide the information earlier but perhaps he would enlighten the committee on what significant resource will be required to begin the move from dealing with emergencies. The full-capacity protocol is a recognition that there is an emergency situation at a hospital and that drastic measures must be taken. It appears that hospitals are in an almost permanent state of full-capacity protocol. I am familiar with the protocol because I worked in the unions when it was first discussed. At the time, we were given to understand that it would seldom be used but now it is almost permanently in use. I do not see a plan to move from emergencies only over to primary care, so I would be interested to hear about that.

There was a reference to 20% of what happens in the health service not being of a high standard. What areas have been identified as not being of a high standard? What plans are in place to bring them to a high standard?

We are all aware of the difficulties with recruiting and retaining staff in our hospitals. We are also aware that a significant amount of money is spent every day on agency staff and outsourcing to the private sector. The Minister has said repeatedly, and I agree, that using agency staff is not good value for money. However, I do not see a plan to convert agency hours into directly employed hours. Is there such a plan? I do not believe there is one but if there is, perhaps the witnesses would share it with us. As part of that plan, has the HSE set targets for the number of hours currently provided by the private sector or by agencies that will be converted into the best value for money, which is direct labour?

Finally, does the HSE have a timeline for the conclusion of the discussions on the GP contract? That will be central to planning for the future. A number of my constituents are GPs and they ask me regularly if there is any news on it and whether there is a timeline. If there is no deadline, it will be an open-ended process. This is being held forth as something that might solve some problems but we are already way behind in those negotiations. We all accept the GP contract is out of date. The negotiating bodies are ready to begin the process. Does the HSE have a timeline for it?