Michael Harty (Clare, Independent) | Oireachtas source

I thank Senator Colm Burke.

All members understand that the majority of consultants working in Ireland at a minimum work to their contract and many or most exceed that. There is no doubt about that. The frustration generated by the "Prime Time" programme and shown by the committee and the public is that it seemed to indicate that public patients were disadvantaged because of some consultants not fulfilling their contract and in respect of the private-public mix in our hospitals. There is a perception that if one has private health insurance, one may have an advantage in getting treatment more speedily in public hospitals. All members know medicine is a very unpredictable profession. Anything can walk through the door and there is no such thing as always or never. Things change very rapidly and it is a very difficult discipline in which to work, in particular in accident and emergency departments, but it is an unpredictable profession throughout the system. A time limit cannot be put on a doctor's work because things can go out of control and doctors quite often work to try to stabilise patients and deliver a proper service. It is an unpredictable profession.

Whatever one may think of Sláintecare, its purpose was to reform the health service and to make the system work. It sends the health system in the right direction. There are many moving parts and much sequencing and phasing involved. There was an effort to cost what was being proposed and that is open to review. However, the Sláintecare proposal is that health care should be delivered based on need, not the ability to pay and that there should be a separation of public and private medicine in public hospitals. I take heed of Mr. Gilligan's comment that a patient should be treated regardless whether he or she has insurance and Sláintecare proposes that the provision of care in public hospitals should not be influenced by whether one has health insurance. There are private hospitals that can supply elective private care but if one turns up to an emergency department it should not matter whether one is a public or private patient.

There have been zig-zag policy changes in the health service and we have moved from co-location and universal health insurance. Sláintecare proposes to clean the sheet and have a coherent ten-year plan for the health service and that is what we are trying to deliver. The purpose of Sláintecare is to ensure there is a ten-year plan whereby one can add year on year, know exactly what is happening and have multi-year rather than single-year budgets. The main frustration voiced in the "Prime Time" programme was that private patients seem to have an advantage over public patients in respect of how care is delivered.

I would like to bring in Senator Bernard J. Durkan to whom I apologise.