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

I have raised questions about the efficacy of primary care centres. They look very impressive and were very expensive but I do not know what they are supposed to do. The theory sounds good but I am not sure. My understanding was that they were to intercept patients before they crowded up the accident and emergency departments but it is not working out like that. They have state-of-the-art facilities but I do not know what is going to happen with them.

In the opinion of the witnesses, where did it all go wrong? I was a member of a health board and we all sat around a table once a month for a discussion. We made decisions and every issue was highlighted long before it became an emergency. A few years ago all GPs were listed in local newspapers as the highest earners in the country. Does the Chairman remember that? Where did that go wrong? Something happened in the meantime but nobody told me what it was, and I am a former Opposition health spokesman. Something happened within the structure of the service and that worries me.

The health services seem to be dumbing themselves down, or somebody is dumbing them down, to a huge extent and they are becoming demoralised. When a GP job was advertised recently nobody wanted it because the talk on the street was that the practice was about to close down and would not exist in five years' time. Who wants a job that is not going to be there in five years' time? Nobody. They were lucky, and delighted, to get one applicant but that person was not from the local area.

What is the problem with the delays in MRIs? What is the cause of that problem and what are the logistical problems with MRIs?

If one goes to a private practitioner in an alternative medicine practice one can have the result of an X-ray in ten minutes. If the X-ray is done in a hospital, one could wait for a long time, up to six months for it. All that delay leads to substantially higher costs.

I would have thought by this stage it would be possible for everybody to access diagnostics through the hospital IT system and the highest quality advice should be available. Why is that not happening? Where are we going wrong again? Mr. Chairman, we are talking about the people who are delivering on the ground. The first port of call will always determine what happens in the system.

My final point relates to an issue I was dealing with yesterday, which will arise tomorrow as well. There was a time a number of years ago when I used to be expelled from the Chamber for kicking up a row when questions about health were not answered. During the health board system, Members had got answers to all their questions and then following the shift Members got no answers at all. Members raise issues because somebody has raised it with them. A patient raises an issue with the GP because he or she has a reason for doing so. When we table a parliamentary question on the matter, we usually get a letter stating if the patient has suffered in the meantime or is facing increased levels of pain, he or she should contact the GP. They have already contacted the GP and the GP has made the representations in the usual way and nothing has happened. Why is that happening? Why is the system not responding? Delay creates problems for GPs and creates a backlog in the system. We need to invest in hospital beds, GP services, nurses and consultants and training. I am not so sure that we can invest all the money this requires all at the one time but I know we need to address the issue of waiting lists at accident and emergency departments as a matter of urgency. There is no sense in having a ten-year plan for that, it has to be done now and it does not require rocket science. From their vantage point, how would the witnesses solve this problem? The rest will follow. I know the Chairman is anxious that I stop.