Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I agree with the Deputy and bow to her professional knowledge in this regard. I will ask the Minister of State, Deputy Corcoran Kennedy, to liaise with her directly on the matter.

I am sure Deputy Margaret Murphy O'Mahony is a WhatsApp fan. I thank her for her question. I thought I had walked into the wrong meeting when she was discussing WhatsApp, leadership contests and so on. While one cannot account for certain colleagues' sense of humour or lack thereof, I assure her that my priority, regardless of any decisions made in my party or by me personally, remains. I am doing this job to the very best of my ability and working with Members across the Houses to do so. I hope both the Secretary General and director general will continue to see that in my work rate in the Department of Health and my interactions with the HSE.

Regarding Bantry General Hospital, an issue Deputy Murphy O'Mahony has raised with me on the floor of the Dáil, I make the point that there must be a bright future for our smaller hospitals. We must consider utilising all capacity within the health service. While there will always be certain specialties and issues of acuity that are best dealt with in larger hospitals and centres of excellence, using every piece of capacity must be what we are about. The hospital group structure affords this opportunity to explore how best to use it.

I am glad Deputy Murphy O'Mahony raised the issue of what we do about a part of the country which, no matter how a post is advertised or a GP sought, still finds itself without a GP. Again, I know the Chairman was - and indeed still is - very much involved in the No Doctor No Village campaign before he was elected to the Dáil and I know this issue is very strongly felt in parts of rural Ireland. I contend, though, that it is also an issue in areas of urban deprivation, whereby the business model of being a self-employed general practitioner may never quite stack up but the societal and health needs of a doctor and a medical practice in such an area is compelling. This is why, as part of the GP contract negotiations, we will consider salaried GPs and how one supports funding GPs where the business model does not work.

I have heard about the issue of nurses and the feedback on the NMBI and registration times from a number of people and I am engaging on the matter. I want to hear from the NMBI about this.

Deputy Murphy O'Mahony asked the director general of the HSE to keep in touch with her regarding the issue of Respreeza. I am sure he will. He was only out of the room momentarily. From my perspective, there are two parts to this. The first part is that we need to follow the law of the land on any drug, and the law of the land says the drugs committee considers something and the HSE makes then a decision. The drugs committee is made up of clinicians. It is important clinicians make decisions and not Ministers. The law, since 2013, is that the HSE leadership team makes a decision whether to reimburse. Sometimes it will make the decision to reimburse but will not have the money and will ask the Minister what he or she will is going to do about it. That is the legal process. The second part - I do not ever intend to stop saying this as long as I am in this job - is that the issue of drug companies and how they engage with the taxpayer and the patient through their representatives is very important. We cannot have price-gouging. I am not talking specifically about Respreeza. No matter how big the health budget is, it will always be a limited pot, very difficult decisions will always need to be made and we need to continually, as public representatives, make sure in our representations that the pressure is not all one way. The pressure should not be merely on the HSE to provide funding; the pressure must also be on the drugs company, and the question of what it is going to do must be asked. I suggest that sometimes on the floor of the Dáil Chamber, while people for absolutely the best reasons rise to ask about the availability of a drug, this only ends up inadvertently increasing the price the drug company demands for the drug. This is a challenge we must all balance.

I will ask the HSE to respond to Deputy Durkan's technical questions about the research being carried out and the kinds of patients turning up. I am asking these questions because if we are to break this vicious cycle of overcrowding which, as the Deputy said, has been ongoing for a decade or more, we must get to the bottom of it. For what it is worth, though, I think we need to consider how we decouple our emergency department attendances from our elective procedures. Currently, when one gets really busy, it directly impacts on the ability to do the other. This leads to waiting lists. Therefore, as part of the capital plan, we should consider how we can increase capacity to carry out more elective procedures, separate and distinct to the acute hospital. I was in Galway the other day. The people of Galway rightly want a new emergency department. The current situation is appalling. However, they also ask whether another site, Merlin Park, can be used to carry out some of their elective procedures. This is the way we need the health service to think.

I agree with Deputy Durkan's comments on the Single Market and drugs. I raised this with the European health commissioner when I met him in Brussels about three weeks ago and I have already signalled to him my intention to put this on the agenda for the next meeting of EU health Ministers.

Industry is very organised in terms of collaborating but member states are not. As a result, our patients and taxpayers are suffering somewhat. The Minister of State, Deputy Finian McGrath, will respond to the questions relevant to his remit.