Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I thank Dr. Turner for his submission. I apologise for being absent at the beginning due to parking difficulty. I have the submission in front of me. A consultant friend of mine has identified - according to himself, anyway - that medical economics is public enemy No. 1 insofar as the delivery of health services is concerned. He cites the extent to which medical economists have been in favour of the reduction of bed numbers and bed capacity over a number of years, resulting in what we see now. He cannot understand that. What is Dr. Turner's response to that?

What is Dr. Turner's response to the phrase we often hear that the health service has an insatiable appetite for money and that no matter how much money is thrown at it, it will absorb it, consume it and be back for more?

How does the witness address the comparison with other jurisdictions in order to achieve the bed levels that other OECD countries have? Recognising the cost involved, how does Dr. Turner feel other jurisdictions are doing in dealing with health services, given that a number of crises have emerged in a number of them in recent years and more are emerging? For instance, how does the witness view the health service in the Netherlands, which was very good a couple of years ago, but is not deemed to be so effective and efficient now? How does Dr. Turner respond to that?

I am sorry for the number of questions, Chairman. I will only contribute once. There was a suggestion referred to slightly by Deputy Kelleher that the private health sector feasts off the public health sector in terms of the resources available and that it advances at some cost to the public sector. How does the witness respond to that suggestion? A programme was done on RTE a couple of years ago which strongly suggested that. I would be interested in the comments of Dr. Turner on that.

This is my last point. If there are long waiting lists, which there are in this country and a number of others at the present time, it certainly points to a deficiency somewhere. Is it a lack of personnel, bed accommodation, management or expertise? What is the cause of it?

For example, a consultant can only work a certain length of time per day. It is not a good idea to work for 18 hours if one is performing surgery. What is the optimum ratio of consultants per 1,000 population? At what level do we get the best performance?

Why is it necessary to have waiting lists? If someone has a list of people waiting, they have either been taking time out or there are too many people coming into the office. How do we marry demand to the available facilities?