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

I am aghast that something of this magnitude was taking place under the radar of the supervision of a number of people. I do not know how it could have taken place. At this committee we have raised on numerous occasions the snags that interrupt the free flow of patients through the public hospital system and nobody ever seems to be able to tell us the answers clearly.

My first question is to what extent was it visible that there was a delay. Was a cause given for that delay in respect of public patients going through the hospitals concerned? If this was not visible, what is the reason? What was the role of the clinical directors? Were they on the site or did they occasionally come on the site? I know reference has been made to the fact they have several responsibilities. However, there must be some means of ensuring responsibilities in a particular hospital were of a nature that would clearly identify any issues that needed to be dealt with, given that public moneys are involved. As the Chairman knows, I have mentioned before that if we had regional authorities on-site, it would eliminate much of this and there would be local senior administration, which in turn would have to account for any snags in the system.

Was this matter brought to the attention of anybody in management before the RTÉ programme was broadcast? Could we know if it was? If it was not brought to the attention of management, what was the reason? Surely there must be some supervisory system within the structures of the Health Service Executive, HSE, particularly at a time when we had shortfalls and over-runs of expenditure in a number years. We were particularly stressed by the extent to which waiting lists and overcrowding took place. Did any of that set off alarm bells in any quarter? Was an audit ever done? We mentioned this before and Deputy Billy Kelleher correctly indicated that any teenager with a clipboard could figure out what was going wrong in a very short and simple time. We have asked the question again and again and nobody seems to be able to identify precisely what the problems are in the process. For example, if somebody is off-site for most of the week and spends one day in the public hospital, what would be the deficit in terms of availability for public health services? What would happen and would anybody ask questions as to where the person might be? Have the financial controllers a role in this area as well and do they accept reports? Has anybody made a report, even before the RTÉ programme? What was done on foot of any such report? Was it brought to the attention of authorities in different hospitals?

I am not blaming anybody but the job of this committee is to find out the facts. It was very embarrassing to find that it took RTÉ - fair dues to it and those involved did the job - to get to the bottom of some of the questions we were asking and to which we could not get answers. It raises a very serious question as to the degree to which we can effectively carry out the job we are trying to do. The people in hospitals are also trying to do a job. It is very important with respect to the morale of staff who give their time fully and freely in committing to the public sector. It is very off-putting for them to find out that a large proportion of people in some areas are off-site, doing other work, but at the same time they are on-site doing private work.

I have one or two other questions. Do the clinical directors practice? Have they a conflict of interest by virtue of the fact that they do practice? Do they manage practice in such a way as to give themselves an advantage while disadvantaging patients and the public health system? Have excuses or reasons been put forward as to why they should be off-site when they are supposed to be on-site in public hospitals? I have a number of other questions and I can come back with them if it is possible. I can ask them now if the Chairman so wishes.