Dr. Gabrielle Colleran:

I think it is ideological. That is only my opinion and my reading of the situation. It is partly because our public health system has been politicised and weaponised. When I was a trainee, consultant posts were really sought after. They were really competitive. There were multiple applicants and the best person would be picked. In 2012, the then Minister, Senator James Reilly, imposed a unilateral 30% additional cut on new entrants' pay. He was warned that it would decimate recruitment and retention. He did it anyway. Multiple Ministers since, including the current Taoiseach, said that this was a mistake, it had not worked, it was not saving us money, and it needed to be reversed. However, nobody has had the political courage equal to desire to say the Government made a mistake. As doctors, we live with the fact that there is uncertainty in medicine. We make our best decisions with the information we have. I am a radiologist. We have an error rate of between 3% and 5%. We know we make mistakes. We have to learn from them, improve and move on. To me it seems there is an ideological or political determination not to admit that this was a mistake. This measure never saved us money. We are spending a fortune on agency locums, far in excess of what we would spend on permanent staff who would be leading, innovating and developing the service for our patients. Everybody seems to see the figures, recognise the impact on patients and realise that this needs to be changed, but there is a lack of political courage to do it.

The Taoiseach made a commitment in the Dáil on 24 October 2018. He said he would sit down with the Irish Hospital Consultants Association, IHCA, which represents more than 95% of consultants, and our colleagues in the Irish Medical Organisation, IMO, and simply do this. So far what we have seen is kicking the can down the road - inaction, lots of talk, selfies and spin. I call on all the members present to say "Enough". We are not a political football. We are the people who look after the patients of this country - the constituents, families, friends and children of the members of this committee. We do not have enough people on our team to provide timely access to high-quality care. Every person in this country should expect that if his or her GP feels he or she needs access to secondary or tertiary care, he or she will get it within six weeks. That is their right. Our Constitution says that the Government has a duty to defend their right to life. The 1 million people waiting on lists, some of whom have been waiting three or four years for access, do not feel very defended or protected by politicians right now.

The five of us who are here this morning should not have to come here like this. We should not have to call politicians out on an issue as basic as having enough people to staff our teams safely. Our number of consultants per capitais half the OECD average, and some of those comparator countries are not rock stars with whom we would want to be compared. Some 20% of our posts are empty. We have the fewest consultants per capitain Europe. Our system is burning out and spitting out our doctors because those of us who are in post are firefighting to protect patients from the gaps in care. We are on intolerable call rosters, we have workloads that are not safe, and we go to work and do this every day to protect patients. We look to politicians to lead us and to give us the resources and the front-line staff to provide the high-quality care that we provide to everybody when they need it, but politicians are ignoring us. They promise to engage with us and then do not follow through. We are willing to meet them any time, day or night, Monday to Sunday. We work those hours 24-7, 365 days a year. We provide the medical cover. There has been enough talk. We have implementation deficit disorder in this country. It is time for politicians actually to do something.