Colm Burke (Fine Gael) | Oireachtas source

A week. My apologies. In real terms, it is what we have taken on in management as we have taken grades 6 and 7 out of the managerial category. It has gone from 4,700 to 5,400 in real terms. We changed how we defined "management". I do not understand why one major hospital in this country had its tenth manager in 18 years start this week. It has had ten managers in 18 years. There is something wrong there. Either the pay structure is wrong or the categorisation of that particular managerial post is not correct. No institution can operate when there are ten managers over an 18-year time period. Issues like that must be examined. We seem to have a huge problem with management and people turning over in positions. When one goes back to a person after six months to see if something has been done, one finds that one is now dealing with someone else. I am finding that very difficult to deal with in the HSE.

I want to deal with doctors and recruitment. A survey was published in the last few days which set out that approximately 80% do not see themselves working in Ireland in the medical area. We have had this problem for ten years but nothing has been done to address it. We produced the MacRea report, but things seem to be going backwards rather than forwards. For example, two thirds of doctor registrations in Ireland in 2015 were of doctors from outside the European Union. We do not appear to be dealing with that issue or to have a long-term plan. We carried out a major review in 2003 setting out exactly what needed to be done and we carried out another one in the last two or three years again setting out what we are doing, but it seems we are not making progress. We can make demands about waiting lists, but unless we have the people with the expertise to do the operations and provide the care, we are going nowhere. We seem to have our priorities wrong and to have put all of our resources into recruiting management and administrative staff while doing nothing to deal with the recruitment of front-line staff. While we seem to have come to grips with the nursing issue, where a lot of progress has been made, we have done nothing about the junior doctor issue, especially in the smaller hospitals in Letterkenny, Sligo, Castlebar, Clonmel, Waterford and Tralee, etc. We have had a particular difficulty retaining junior doctors, which is an issue we must address if we want to provide the services people want from our health care service.

I thank the Minister for dealing with these issues. I will come back after my matter is dealt with in the Seanad.