Simon Harris (Wicklow, Fine Gael) | Oireachtas source

On speech and language therapy, I reiterate the points the Minister of State and I have made. I fully agree with Deputy Durkan. The issue that he has raised highlights the need for us to create community teams in areas. I say that because where an area becomes so wholly dependent on any one healthcare professional, and things can happen in all of our lives in terms of career breaks, maternity leave, paternity leave and whatever, we obviously need to make sure that we do not build a system that is wholly reliant on one healthcare professional. That is why I think the reforms we are bringing in through the creation of our community network teams, but also our work with education, lessens that reliance on any one individual.

What Members are seeing is that we are continuing to increase investment and staff numbers, yet we are continuing to see some of the challenges that Deputy Durkan has outlined. That is certainly the direction of travel.

On the treatment abroad scheme and-or the cross-border directive, I have a very long table, which I will send to Deputy Durkan and circulate to the committee, that shows the procedures. The major ones are orthopaedics and ophthalmology, for which people travel abroad. I am glad that Deputy Durkan raised an interesting point about whether the taxpayer is funding treatments abroad that we should be doing here. The short answer is that in some cases we could be doing better in Ireland. For example, I constantly hear about ophthalmology and people going to the North to have their cataracts removed. We have opened a new theatre in Nenagh at a cost of €1 million last year, which it is fair to say has dramatically reduced the number of people waiting for cataract procedures and dramatically increased the capacity for this country, not just that region, to meet the cataract demand in the health service. We must be looking constantly for opportunities - one might use the term low-hanging fruit - where we have level 2 hospitals, which back in the day were big emergency hospitals but no longer have an emergency department and have capacity. Of course, that requires staffing, so it is not always as easily done as I have outlined. The theatre in Nenagh is an example of where we are trying to do more here than we previously had the capacity to do and people had to go abroad. We had to send children abroad for the treatment of scoliosis. Nobody here, including me, thought that was acceptable, and we are now building up the capacity of our theatres and surgeons to ensure we can have a sustainable service in Crumlin and Temple Street and ultimately in the new children's hospital.

To respond to the question on the HPV vaccine, I will have to rely on Dr. Henry to respond to that technical question or to revert on it.