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

I served on the largest health board in the country and learned some lessons during that time. As I have stated on many occasions, the HSE is not the appropriate structure to deliver health services in this country. The sooner we return to regionalisation, as proposed in part under Sláintecare, the better. However, there are issues to be addressed.

I do not accept the notion implicit in the comments of the Minister of State that politicians asking too many questions is slowing down the system and costing a lot of money. That is rubbish. It costs no more to answer a question quickly than it does to answer it slowly. In fact, the reverse is the case. To answer it slowly could cost up to ten times as much. People afraid of certain questions being asked are hiding behind claims that the questions cannot be answered.

How does the system work? Is it working? I do not think it is. It should be simple to transfer a seriously ill patient from one hospital to another, but there are major difficulties in that regard. Last summer I became involved in the case of a patient with private health insurance of whom a transfer was sought. I thought the public sector would be delighted to take a patient with private heath insurance and so on, but that was not the case. There was a shortage of beds. The hospital had only a couple of vacant beds and they were reserved for emergencies. The man was in a coma. The hospital staff were asked whether his case would be considered an emergency. We should find out what is slowing down the system and why it is not functioning as it ought. Henry Ford devised a system that was far more efficient than others in operation at the time and produced better goods more quickly, cheaply, and effectively. I do not suggest that we do things on the cheap, but we can do them far better and more quickly, effectively and efficiently than is currently the case.

The National Treatment Purchase Fund is a means of removing patients from the most sensitive areas of our waiting lists. The treatments must be paid for one way or another. If it cannot be done in one system, let us do it in another system, whether that be inside or outside the system or country. There should be an inevitability about treatment being provided. If it cannot be provided within the public system, we should get somebody else to provide it. The waiting lists are not a reflection on the present or previous Government. Lengthy waiting lists have been common for many years. Patients may unnecessarily wait up to ten years in excruciating pain for a hip replacement. They are told to go to their GP and get more painkillers. That is wasting money. The way to use the time effectively is to go to the centre of the issue and deal with it.

I am a little concerned by the issue of the State Claims Agency and the increase in costs to which reference was made. What is the reason for the increasing demand in that regard? Is it a change in culture or is the State exposed to a greater number of claims arising from the delivery or non-delivery of services? I will not go into the issue of unqualified medical personnel who infiltrated the system as that was addressed at a previous meeting. The existence of such issues causes me considerable concern.