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

I am sorry for being absent because I manage bilocation - hopefully effectively. I welcome our guests. This has been a long day on this subject and other subjects.

On the ongoing administration of health services, we have two bodies, the HSE and the Department of Health, and to my mind the twain shall never meet. In my opinion it does not work that way and it will remain my opinion. I believe it should be regionalised similar to but not the same as the previous health boards. I think it would be more effective, accountable and representative in terms of having all constituent bodies represented on a board somewhere in a region directly relating to the region for which it dispensed the services. At another meeting we have already discussed the realignment of the hospitals in line with something like that.

To what extent has the HSE looked at the requirements in the health services in terms of elective surgery, acute bed accommodation and accident and emergency department accommodation? If the HSE has quantified it, how has it quantified it? What is the HSE's proposed resolution to what is clearly a problem? I asked this question previously. I did not get the answer but I think it came by accident. Presumably we need more beds and more staff at accident and emergency departments to clear the problems that arise every year at an acute time. In the event of building up the services to the extent that this can be dealt with without major controversies and overcrowding with consequent dangers to patients, staff and everybody else, how does the HSE then deploy the service that is capable of meeting that surge the rest of the time? I think I know the answer, but I will not say it until I hear it again.

We have spoken about hiring and retaining staff, which seems to be a huge difficulty - more so than anything else. We have had comparisons with various jurisdictions over recent years, including with the one across the water next door, which also seems to be having serious problems at its accident and emergency departments, despite having been seen as the Rolls Royce of services up to some time ago. We also know about the Dutch, French and Canadian health services, all of which have been much vaunted and are still not perfect because they seem to have the same problems.

I did not mention this previously but is appalling to have someone awaiting elective surgery, such as a hip operation for example, where they are suffering acute pain over a long period. They may have to wait for two years. I have dealt with many people, as I am sure has the Chairman, who have waited for two years and more in severe pain, which is no help to them whatsoever. There have been many discussions, meetings and protests over emergencies and various things that have gone wrong in recent years, some significant and some that should not have gone wrong. Have we learned from all those things? Can we put in place within a reasonable time a resolution to them without having to wait four or five years of suffering the same anxiety as we have at the moment?