Michael Harty (Clare, Independent) | Oireachtas source

The bed capacity review of last year indicated that if substantial health reforms were implemented during the next ten years, there would be a need for 2,600 beds, but if substantial health reforms were not introduced in the next ten years, there could be a need for up to 8,000 beds. The actual figure will probably be somewhere in between. Obviously, there is unmet need in the system, as evidenced by the trolley count which is a crude measure, but nevertheless it indicates the lack of bed capacity to meet the needs of those on waiting lists.

When will we see new build beds being provided in the next ten years? Sláintecare suggested we should have elective surgery-only hospitals. My understanding from the Sláintecare implementation strategy and plan is that the choice of location and the design of hospitals will not be available until 2021, but perhaps that is not accurate. The Minister can clarify the matter. When will we see the expansion of bed capacity to meet unmet need? There are approximately 450 consultant vacancies in the system, which is undoubtedly leading to a delay in service provision and meeting unmet need. Pay disparity between consultants appointed pre and post 2012 is a factor, as are working conditions. It is a huge problem in service delivery.

It is very welcome that the Department and the Irish Medical Organisation, IMO, have come to an agreement on the restoration of funding for general practice, but it leaves the issue of many communities being left without a GP when one resigns. The issue is most acute in rural areas, but it also arises in urban areas and towns. Will the Minister speak about guaranteeing a community will have a primary care service independent of market forces which often dictate whether a GP will be replaced when someone retires or resigns? There is a proposal which I presented to him last year for a fellowship programme which the University of Limerick, in particular, is proposing. When a practice becomes available but cannot attract a candidate, the graduates from the GP training scheme would rotate through the practice, perhaps sharing their work commitments to hospital medicine and research in order that young GPs could supply a service to a community that cannot attract a GP. They could maintain their university connections and continue to carry out research. There is a proposal that, as part of a fellowship programme between the university and the HSE, services be provided for a community that cannot attract a GP.

The Minister might comment on the three items to which I have referred.