Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

Let me go back to my original question, on the issues that attract public attention and upset patients and the general public and which actually demoralise those working at the coalface in the health services. The first is overcrowding in accident and emergency units. Can the HSE put in place troubling-shooting systems that will find out precisely the cause in each case, as it arises? There are not so many that they are beyond enumeration, but they are of sufficient importance to require an immediate response such that the public and patients can see something happening. The question that comes to mind is why there is so much overcrowding at accident and emergency units. Is it because people bypass their general practitioner? Is it because they have been on a waiting list for general hospital services or elective services for a long period? I am just asking these questions off the top of my head. I have dealt with such cases myself. What are the issues? How can one put in place a system that would identify the cause or causes, isolate them, set them aside and deal with them? This is a major issue for the health services this year. Without doubt, the public in the health services will become depressed as a result of implied criticisms. There is actually no criticism but the fact of the mater is that the system is not flowing smoothly, which is a problem.

Another issue is waiting lists for various procedures in general hospitals or public hospitals. Again, there is a need for an urgent appraisal of the causes of the stoppages and slow-downs. Is it a lack of personnel, consultants, hospital doctors, theatre staff or theatre availability? A criticism I hear from consultants is that, in terms of procedures, there could be a 15% difference in the amount that could be done in a public hospital by comparison with a private hospital in the same day. The questions that arise in this regard are why this is the case, why we cannot identify the problems and why we cannot address those issues. Let us not forget that there are theatres, including clean-air theatres, that have never been used and that are idle all the time. They have the most sophisticated technology in the land, or in Europe, in fact. To restore public confidence in the system - this is not a criticism of the HSE or any personnel anywhere - we simply have to address this. If we do not do so, we will have failed and I will have failed as a member of this committee. The health services will have failed if we cannot address these issues.

What is the most effective use of consultants throughout the public health system? Are they effectively engaged? Are we diverting towards them a steady flow of patients that they can deal with daily without having a hiccup and having to wait for two or three days for the next patient to come along? What are the causes? Can we address them? How soon can we address them?