Colm Burke (Fine Gael) | Oireachtas source

I congratulate the Minister and Ministers of State, and wish them every success. I am delighted that a Minister of State from Cork is dealing with the Department of Health. I look forward to working with everyone.

I refer to future planning of hospital services for Cork. I note the last line of the report I received. As I have said, the population of Cork city and county has increased by 130,000, from 410,000 to 542,000.

Senator Buttimer and I had a meeting with the Mercy Hospital group a few months ago. Last year, they had to cancel 40% of their elective surgery because of admissions through the accident and emergency department. Their major problem was that there was an increase in 12% in the over 80 age category of patients being admitted through that department. It is more difficult to discharge them and, therefore, they had to be admitted. It is in that context that I asked about new hospitals for Cork. The final line in the reply I received is that there is no definitive decision that Cork will be included in the next national plan. However, this is a priority area. Major funding has been allocated for hospital development in Dublin. Three or four new developments are going ahead in the city but there is a need for a centre of excellence in Munster and not just for Cork. The Minister needs to focus on that rather than diverting services to Dublin. Will he respond to that? The other aspect of this I am concerned about is UCC seems to be doing the driving on this matter. This is not a criticism of UCC but any new hospital must be patient-focused and located where it is needed and not necessarily where a third level institution needs it. We need to get hold of this project and not allow others to make the running. I ask both the HSE and the Minister to respond about where this is going and where we will be in six months on this issue because I will not want to repeat the same comments then. I may not be an Oireachtas Member in six years but I do not want someone else coming in here in then to ask the same question. I would like clarification on where this project is at in respect of current planning, identifying a site and forward planning.

The second issue I would like to raise relates to respite care. I have a serious concern about this in the Cork area, particularly in respect of provision for people with disabilities. I have met a number of parents who cannot access respite care. In fairness, I received a detailed reply dealing with the HIQA issue and the maintenance of standards, with which I fully agree. However, this is also about forward planning. I asked whether the HSE has age profiles of those with disabilities who require respite care and of their current carers. For instance, I was contacted by a man who will be 80 next month. He drives his daughter to day care in the COPE facility, which provides an excellent service, in Cork every day. He drops her off in the morning and collects her in the evening. The journey is between 15 and 20 miles each way. He will not be able to do that forever and, therefore, I am wondering about the long-term planning in respect of services for people such as his daughter. Will the Minister outline what is being done to identify the numbers involved and to facilitate these carers who have been providing the necessary care at home for years?

I hope people do not take up me wrong on the third issue I would like to raise, which is the increase in the number of administration and management staff. I am a little confused by this. This relates to governance. When was the decision taken to increase staff numbers and how was it taken? The number of staff at senior level has increased from 201 to 289 in two and a half years, which is a 43.5% increase. Has a clear plan been set out for recruitment at administration and senior management levels? At what stage is there a cut-off point? This has been a phenomenal increase in numbers in comparison to other areas. I previously instanced that the number of public health nurses in the same period increased from 1,460 to 1,499, an increase of 39, yet on the most recent figures, the number of administration and management staff increased by more than 1,900. Where is the cut-off point? I would like to identify each of the 71 positions that were created. Some detail has been provided on that but I am still not satisfied as to why that increase occurred. Will somebody outline the cut-off point? Will the increase in senior management numbers continue? What is the final target number? There are 289 management staff now. Will that number reach 350 this time next year? What is the plan? That has not been in the public domain.

Finally, I refer to the issue of hospital doctors. I understand that 40% of doctors are non-Irish graduates. We brought in the McRae report which set out clear plans for retaining graduates. Has a review been conducted of whether this report has achieved anything and whether additional changes are needed to retain graduates or to attract them back to the State? Ireland is first among OECD countries for bringing in doctors from outside the jurisdiction and, indeed, from developing countries. It is a serious issue that the Government and the HSE have not got a handle on yet.