John Brassil (Kerry, Fianna Fail) | Oireachtas source

There is no problem. It is enlightening to have listened to what everybody has said and I have removed all the questions I had that have been asked. I welcome Mr. Reid and wish him the best of luck in his new role. I have great admiration for him for taking on the challenge, and the fact that he is willing to take it on demonstrates that he is a committed man. I wish him every success. Following the Minister's comments, there is a unique opportunity here and the witnesses have been given a political "free pass" in the form of Sláintecare. If they implement that policy, nobody in this room could fault them in any way. Any time anybody might try to do so, we can be referred to the document that we in this room produced, which was endorsed by the entire Oireachtas membership.

Senator Dolan is on my immediate left and I will start with disability matters. The Minister of State, Deputy Finian McGrath, is present and I endorse the point made about Rehab. I am delighted that matter has been resolved but I anticipate a number of other organisations awakening to those events. The Kerry Parents and Friends Association, which does excellent work in County Kerry, issued a statement indicating its budget is severely challenged for 2019. I might speak a little more about that offline. The disability sector is an area for which we must continually fight as those involved are so tied up trying to look after their loved ones and care that they do not have the time or energy for it. It is always left to us to advocate on their behalf and the Minister of State knows I will continue to do that. I have brought to his attention a number of individual cases and he has made time to meet those people. I thank him for that but I would like some follow-up so I will speak to him offline in that regard.

I will comment on Mr. Reid's opening statement and the letter he sent about financial control. I greatly welcome that and it is a good starting point. I will throw into the mix the €100 million overrun that he is seeking to avoid but there is also €100 million available in savings in biosimilar drugs. I have been going on about it ad nauseamfor three years now. This biosimilar policy is meant to be coming and money could be saved. The HSE is looking to make savings and they are available. Mr. Reid should not take any more excuses or reasons for deferral; the money should be taken because we need it. When the Minister of State is looking for €1 million or €2 million and there is €100 million available, is it not time to avail of it?

I am aware of a review of Ireland's reimbursement process in its entirety that is ongoing and I have some very specific questions on it. I might ask them afterwards.

I would like progress on group recruitment for hospitals. The recruitment area is in itself a minefield. I am most familiar with the hospital in Kerry and trying to recruit for a slightly isolated hospital when doctors want to go to a centre of excellence in Cork. There should be recruitment on a group basis across the board and if there is a shortfall in one hospital - perhaps a category 3 or category 2 hospital - the category 4 hospital should intervene and send people to those facilities. Along with that is the consultant pay discrepancy, and I do not foresee any resolution to the recruitment crisis until that is dealt with. Sláintecare recommends that we do that.

I have stated many times that savings could be made as the budget for the fair deal scheme and home care packages are dealt with separately. The cost of a patient in a fair deal scenario is at least double, if not triple, the cost of keeping him or her at home. In most cases the person would want to be kept at home but he or she is dealt with under two budgets. When a family seeks home care, the district nurse will ask if they have considered the fair deal scheme because he or she wants to hold on to the budget. Those budgets should be in one pot, as this would generate significantly better value for money.

The Minister met pharmacy representatives at their recent conference.

I understand there was a very positive exchange. The advancement of the minor ailments scheme would provide great value. There is the issue around the provision of contraception, which is another area where significant savings are to be made.

I am a pharmacist and will declare my conflict of interest, but we have not yet dealt with financial emergency measures in the public interest, FEMPI, restoration for pharmacists. As a group, they are a very underutilised resource. It is only fair they get the same treatment as every other healthcare professional. Will the Minister look at that?

With regard to ophthalmology in my area, as far as I am aware, the National Treatment Purchase Fund does not cover ophthalmology for patients in the Cork and Kerry region, for some reason. If I am mistaken, that is fine, but I do not think I am. I would like it to become available because there is a very large waiting list for ophthalmology in the Cork and Kerry region which I very much wish to be tackled.

On the recruitment issue again, by way of an example, this time last year the cardiologist in University Hospital Kerry handed in his notice. Following parliamentary questions and so on, we were told the recruitment process had begun. Following up almost 12 months later, I got the same answer except it was said that the advertisement for the job would commence shortly. Therefore, 12 months after the person handed in his notice and we were told the recruitment would start, the job has not even been advertised. When Kerry Deputies met University Hospital Kerry management recently, they were as frustrated as we were. It is a systems failure. It just goes up to the national recruitment agency and seems to go round in circles. Nobody seems to have responsibility and, as a result, it has not happened when it should have happened. In the early part of his role, will Mr. Reid try to come to grips with that recruitment issue and to cut out whatever red tape can be cut out?

I would ask a similar question about nurses. How many nurses are in the system and how many nurses are needed in the system? Again, when we met management at University Hospital Kerry last week, I was pleasantly surprised that the number of nurses recruited in the past 12 months has been significant, but that message perhaps does not get out there and gets lost in all the different controversies. I would like to know the facts as to how many nurses are in the system compared with how many we need. It is sometimes easy to make political points but they might not be entirely accurate.

I will leave it at that for the moment. I will come back to the witnesses in my second contribution on the specific issue of the review of the reimbursement process.