Ms Brigid Doherty:

We absolutely agree with Mr. Doran's opening statement and Dr. O'Conor echoes how we feel exactly. We do not need another report or review. We must get on with this. Personally, I am passionate about community care. That money must be ring-fenced and we must do something now, even if we start small. It concerns me greatly that there are community intervention teams in some parts of the country but not in others, so if I need antibiotics and I happen to live in Thurles, I will get them if I have a medical card but if I have VHI, I will not. Neither will the VHI cover my patch so I will have to sit in Kilkenny hospital for three weeks purely to get antibiotics. Something must be done about that. It is a two-tier system, with medical card care by the community intervention teams provided by the Health Service Executive, HSE, versus the high subscriptions to private health care where they pick the patches for community care. That is unacceptable and the issue must be examined.

There is the issue of developing community care teams. There are plenty of skilled nurses out there and they need to be developed. Particular care does not need to be provided in the accident and emergency departments. I will go to the basics, like block catheters etc. When a patient arrives, he or she must arrive by ambulance and these people will sit all day in the accident and emergency department before being taken home by ambulance. There are dreadful conditions, with bursting bladders for example. That is very basic but how it is. There are many other aspects to consider but we must get on with it, even if we do it in small patches and not necessarily the whole country together. Palliative care specialists do brilliant work and I ask that they integrate their services with community nurses as well.