Oireachtas Joint and Select Committees

Wednesday, 28 March 2018

Select Committee on Health

Estimates for Public Services 2018
Vote 38 - Health (Revised)

9:00 am

Photo of Jim DalyJim Daly (Cork South West, Fine Gael) | Oireachtas source

We must be careful not to talk the GP career down to new aspiring candidates. My own son was with me at the event last weekend, and he told me he would love to be a GP. We have to ensure that we protect the future. These efforts will be made in tandem. We must increase the number of training places. We cannot simply state that all new GPs will all emigrate and throw our hat at the issue. However, we also have to reform the contract. We must make it fit for purpose and make it an attractive career. Those goals must be pursued together and I think the Chairman and I both recognise that. It is not a case of doing one or the other.

I was recently in New Zealand, representing the country on St. Patrick's Day. I was amazed to hear New Zealanders tell me of their high regard for the Irish medical workforce. They see it as incredibly talented and well trained, which we can be very proud of. They had one difficulty, however; they cannot retain these workers. They all want to go back home. This is the issue they are experiencing on the other side of the world. Irish professionals come for a short while, but they do not commit. They are not willing to stay. That includes different disciplines, including nurses, GPs, physiotherapists and everything in between. That is the other side to this. The New Zealanders said to me that the Irish workforce is very mobile, even in the far-off countries to which they go. They do not necessarily settle there but they like to go for a while. That has always been part of the Irish psyche and make-up.

Bed capacity and ambulatory care have been referred to. The move towards ambulatory care is a part of the national development plan. It informs the decisions on where to locate elective procedures and where those hospitals will be built. They will always be connected and related to the acute hospital but those decisions are being taken.

Recruitment for model 2 hospitals has been raised. The questions mentioned are challenges for Kerry General Hospital and Bantry General Hospital. This is a particular challenge for remote hospitals, model 2 hospitals and some model 3 hospitals. The South/South West hospital group is currently undertaking a review of all its consultants and their particular skill sets to see where the demand is more acute and attempt to find solutions.

I discussed it with the hospital group on Monday of this week. It assured me that the review would be completed within the next two to three months and that it would devise proposals to deal with the consultant challenges that have been mentioned. I expect a number of recommendations from the South/South West hospital group, which I suspect will be replicated nationally.

I do not have information on insurance companies to hand but I can get someone to revert to the Chairman on the issue.

As to the €460.2 million figure of appropriations-in-aid, the recovery of cost of health services provided under EU regulations is €280 million and the receipts from certain excise duties on tobacco is €167.605 million. They are the main components. There are a number of others, including recoupment from social insurance for certain ophthalmic and dental treatments, miscellaneous receipts, the Dormant Account Fund, which is €2.7 million, and receipts from pension-related deductions in public service remuneration, which is €3.9 million, but the bulk of the figure relates to the recovery of cost of health services provided under EU regulations.

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