Simon Harris (Wicklow, Fine Gael) | Oireachtas source

In the interests of efficiency I will answer the questions that are relevant to me and ask the HSE to come in.

Deputy Kelleher is correct that the policy of treating private patients in public beds should be kept under review. It arose when there was no mechanism for private patients to be charged, which was not equitable in a public health service. On foot of his sincere interest, and it is a prudent thing to do, I will ask the Department of Health to produce a report on this matter, how it has grown and its impact on bed numbers, and I will share it with the Deputy and this committee.

I am very pleased to hear the Deputy refer to bed capacity being tied to recruitment because I have consistently heard people on the airwaves saying time and again that if they had more beds, the crisis would be solved. That is not a fitting comment for some of those people because they know that in their own hospitals beds are closed - for example, there were 90 closed yesterday - due to staff shortages. While I accept there is a bed capacity issue, the beds of themselves are not a realistic answer. Only beds that can be staffed are a solution. The two must go hand in hand. The bed capacity review should be able to inform the recruitment needs of the health service.

Theatre assistants are a sensitive issue. This is a sensitive time for industrial relations and engagement with unions in the health sector but I hope that in the context of the public service pay talks, new grades in the health service will be considered seriously. In other countries theatres function well with fewer nurses and other assistants. That enables the nurses to deploy their skills more appropriately in the acute hospitals.

The comments on waiting lists are fair because there is a role for management and one for consultants. We have to get away from the idea that the consultant owns the patient to the extent that until the consultant sees the patient who has been referred to him or her, the patient cannot have a procedure. We saw a good example of what I describe as pooling in the Royal College of Surgeons of Ireland, RCSI, hospital group, which includes Beaumont, Cavan and Our Lady of Lourdes in Drogheda, such that if a patient was offered a procedure in Beaumont but there was no capacity there, it would be offered in Cavan or Louth. As a result, waiting lists in this hospital group reduced significantly compared with other hospital groups. Deputy O'Reilly’s integrated waiting list approach supports this. Pooling and using the group structure to maximise capacity will have to be a priority for our waiting list efforts in 2017.

On the issue of the National Association of General Practitioners, NAGP, and the Irish Medical Organisation, IMO, it is not for me to adjudicate on who has the most members nor is it for me to adjudicate on why there are two different organisations or a doctor joins one or both, as many general practitioners I meet tell me they have. On taking office I said, and I meant it sincerely, that there is a need for the GP contract discussions to be inclusive. The process I have put in place, following advice from officials, consideration and engagement, is much more inclusive than any we have had on general practitioner, GP, matters. In the past the NAGP was left out in the cold, looking in the window, as it were. In this process the IMO, which has a long-standing history of negotiating as a representative body and has a framework agreement, not one signed by me but signed by the Department of Health and the IMO, is negotiating a new contract with the NAGP being afforded a formal consultative status that it has never before had. I have received correspondence from this committee on that but I am trying to balance the need to ensure the process is as inclusive as possible with ensuring my Department honours an agreement and framework already in place. I would say to the NAGP that this process enables it to have a greater role than ever in any discussion on any matter to do with general practice and the Department of Health. I will meet the NAGP in the coming weeks and will tell it to take that step and build on that. A new GP contract is crucial but I have to respect a framework agreement with the IMO and show willingness to ensure the voice of the NAGP and its members is heard. I am trying to get that balance right in an appropriate manner that enables us to deliver a new GP contract.