Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I will answer the speakers in reverse order beginning with Deputy Shortall's issues, many of which were similar to those raised by Deputy Collins relating to slippage and timefarmes. I want to be honest about this. I do not criticise anybody for being ambitious but some of the timeframes were somewhat unworkable, and I do not say that to be critical. We had a plan in May, it was debated in the Dáil in June - in fairness, Deputy Shortall noted the changes in Government - and the idea that we would have a lead executive, which the members and I would want us to have, in position in July was always going to be a bit of a stretch. We can probably accept that much. It is now November and I accept we do not have a lead executive. I take the point made by Deputy Shortall, as chair of that committee, of the need for urgency to be applied to this. I assure her that urgency is being applied to this. It is with the Public Appointments Service. There is an executive search currently under way nationally and internationally. The Deputy asked about head-hunting and if anybody can be directed through that process. Everyone needs to go through the process of the executive search. It is appropriate that there is one because we need to get the right person to do this job. That is where it is at. It will be done as quickly as possible. The process is under way through the executive search with the Public Appointments Service.

I take the point that colleagues made that they would have liked and expected that the lead executive would be putting in place the implementation plan. I also have to accept the reality that the Taoiseach, on his first day in the Dáil when he appointed his Cabinet, listed three things for me to do, one of which was to make sure we had a draft implementation plan ready for the end of the year, so I did not wish to stall on the issue. It is a draft implementation plan with the wording used in the Sláintecare documentation. There will be an opportunity for the lead executive to finesse that and to have an important input into its own team as well. We have brought in consultants to help formulate that in a quick timeframe, and that is a matter of public record. I hope to be in a position to share that once I go to Government with it very early in the new year. This committee is probably the appropriate body to consider that and I will be happy to debate and talk it through with colleagues.

On the ehealth programme, I take the point that we have to spend to save. We rolled out the ehealth records in the Rotunda Hospital the other day where we now have digital recordings with regard to babies, similar to the records of other babies but with an electronic health record. It is the third maternity hospital in which we have rolled out the programme. We have to do much more of this and to do it much quicker. I hope that will be reflected in the ten-year capital plan. Clearly that does not mean that we will not be doing it for ten years. It should enable us to speed up on some of that.

I note the context in which Deputy Shortall said the impact study was to be done. I would point out that Sláintecare says that this would be disentangled over a five-year period and it refers to commencing that in the second year. The study will be completed within nine months, so by the end of next summer we will talking about the outcome, which will provide us with a good basis. For the record of this committee, my view on that is clear in that I support the disentanglement of public and private practice. I said it at the Irish Hospital Consultants Association conference in Limerick but the impact study is a prudent way to go as well. I am clear about what I would like to see happen in that regard.

On the issue of the consultant contract, there is a need for a new contract. The programme for Government commits to it. It will probably be possible to implement Sláintecare without a new consultant contract but, nevertheless it is something we need to address.

I thank Deputy Shortall for acknowledging last night's television programme it. It was fair but what we do not want to do is to group everybody together and with respect to the good elements that are happening to have those people discouraged or demotivated. It is fair to say that a significant minority have brought the system into disrepute and have let down many of their colleagues. At a hospital group level, people are meant to be ensuring these contracts are fulfilled. I cannot be satisfied that is happening now on the basis of what we saw last night. Senator Conway-Walsh asked did I know about it or was I surprised. I think everybody in this room has heard an anecdote or a concern about whether doctor X or doctor Y is doing too much private practice. Through its excellent surveillance work, RTÉ "Prime Time" programme has given concrete evidence on that.

As to what I am going to do about it, I spoke to the HSE again this morning on the issue. I have been informed, as I would expect to have been the case, that there will now be formal investigations into each of the cases highlighted in the programme last night. I do not want to say anything to interfere with that due process. Due process is important but the Deputy is correct in terms of what is meant to happen when somebody is in breach of their contract in terms of the fees being paid back when those fees are meant to go into a research and study fund. I expect those formal investigations to proceed and I have been made aware this morning that they will. I have also made it very clear, and the Deputy can believe me or not on this, but long before last night's programme we were discussing in the Department the need for having a more robust mechanism in place. I want an absolute assurance that in 2018 there will be robust mechanism in place, like there would be for any other health care professional, to make sure that people are fulfilling their contractual duties.

I would also make the point that there is a legal dispute ongoing with the consultants on the non-implementation of pay increases under the contract. It is likely that poor contract compliance will be argued strongly as part of the State's discussion. We cannot have a situation where some cohort is arguing in regard to the non-implementation of the contract where we now see significant concerns about the implementation of aspects of a contract that the contractor has an obligation to fulfil. I do not wish to say too much more than that other than I have been very clear here. I expect the HSE to provide robust mechanisms that will satisfy me and that, in turn, I can try to satisfy the Oireachtas that there is proper monitoring in regard to the contract. I thank the Deputy for acknowledging that it is not my contract, it is one we have inherited and about which I have significant concerns.