Michael Harty (Clare, Independent) | Oireachtas source

Being conscious of time, I am just going to move on. We have been here for three hours now.

I would like to go back to the Minister's reference to the GP contract negotiations. As he knows, the committee wrote to him following a meeting two weeks ago stating that there was a strong feeling within the committee that both groups should be given equal status and parity of esteem within those contract negotiations. The Minister has referenced the framework document again today, which seems to be an inhibiting factor in terms of allowing both groups to have equal status. This GP contract will underpin general practice for perhaps the next 20 or 30 years. It will be the central component of moving from hospital-centred care to primary-centred care and it will most likely be a GP-led primary-centred service, particularly dealing with chronic illness. If we are to have the best outcome of those contract negotiations, we feel it is essential that both groups have equal status. This is about the patient and getting him or her the best service. We need to get the best contract to give the patient the best service. In that context, will the Minister tell us the reason the framework document is inhibiting equal status for both groups? Unless both groups are involved in the negotiations, we will not get the best contract and outcome for patients.

The topic of governance has arisen in many of the committee's hearings. Will the Minister outline how the Department interacts with the HSE in terms of governance, accountability, transparency and responsibility? For instance, the maternity strategy was discussed at this committee on two occasions. Our maternity hospitals in Dublin have a mastership model of governance while our maternity structures do not have that autonomy of governance. Professor Kenny feels that if they had the same autonomy of governance in Cork as is to be found in the maternity hospitals in Dublin, which have the mastership model, they could improve the quality of service they provide to their patients, including the shortening or elimination of waiting lists. We expect clinical excellence of our clinicians, but we must also have managerial excellence from our managers. Deputy Kate O'Connell referred to doctors having an ethical responsibility to do their best. How can we ensure that our managers have the same responsibility to deliver excellent outcomes? We need a governance that is transparent and accountable. Perhaps Mr. O'Brien and the Minister would address those issues.

I call Senator John Dolan, who will be followed by Senator Keith Swanick and Senator Kieran O'Donnell.