Dr. Laura Durcan:

We are here because we want to help. The only reason we come to any of these things is because we want to help and we really believe in the public system. I could say the same for everybody who is on the Joint Committee on Health. The only reason we show up in the morning is that we believe people should have timely access to excellent care and that it should not matter where someone lives, how much money he or she earns, or what is in his or her local hospital. All of those things should be irrelevant. Every person should have equal access to excellent care. Once people get into the public health system, we do an excellent job. They are really happy. When we survey our patients, we find that the ones we have seen are really happy. As has been said, it is the million people we have not yet seen who are disgruntled and they are totally entitled to be. They have not accessed care.

The Government has a fear of dealing with us and with doctors in general. It has this horrible fixed narrative that health is a big black hole or an unfixable problem where good money goes to die. The Government feels that it continues to pour resources into this big black hole and nothing comes from it. In a way, the Government chooses not to engage with us because it does not want to face up to that black hole or start looking at how to pull back from it.

I look at examples of solutions. This morning I was in a clinic and I met one of the nurses. She told me to make sure to tell the committee that the staff are doing a great job. I said that I would. The truth is that the people who work in our health service do a great job. We have fabulous healthcare workers, but we do not have enough of them.

I can give my own hospital as an example. I work in Beaumont Hospital. We used to be terrible, but our numbers are now excellent. The rheumatology department in Beaumont Hospital went from having two rheumatologists to having three. Our waiting list went from three and a half years to less than six months. I delved into the data for the other specialties in our hospital. There were thousands of people waiting for longer than 18 months to see an orthopaedic surgeon. The hospital added 1.5 new posts and changed the triage system. Everyone now on that waiting list has been there for less than nine months. That is pretty much the only orthopaedics department in the country that has achieved that. Now, nine months is still terrible, but it is not the same as waiting to be seen for a year and a half. The same can be said for respiratory care. Nobody has been waiting for longer than six months because a new body was introduced and took the tail of the waiting list. The waiting list is now gone.

The only places in our hospital that have not seen improvements are the places where people have resigned and left. We have lost three or four people in the dermatology department to the private sector. That waiting list has skyrocketed. That is the only place where we have had to put some of the workload out to tender via the National Treatment Purchase Fund, NTPF. Yesterday, we were discussing the cost of getting people out for their dermatology assessments, their biopsies and their subsequent treatment. I will not outline the numbers because I would be killed, but they were massive. I was absolutely astonished. That is the only place in our medical service where we are outsourcing. That was a huge cost. It certainly cost more than it would cost to hire three consultants a year.