Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

There is something missing. While this is not a reflection on anything that Mr. Owens has said, there is something wrong. We educate to a high standard and we export our graduates afterwards. Do the graduates feel they have any sort of moral responsibility to give the first year or second year to their native country? Would that help? Would it be of any benefit if they stayed for a specified period? I do not know.

Those delivering at the coalface in the health services should be able to give us some indication as to how much money is required to provide the service. This is notwithstanding the fact that, before and during the boom, we had waiting lists and we still have them. The witnesses say they are growing but if we are exporting our medical professionals, they are going to grow.

Incidentally, the way we operate, there are backlogs everywhere and waiting lists for almost everything. This has been the case for years and we have become accustomed to it. That is the culture. It is a misleading culture and it is damaging to the system, in particular to confidence in the system. We start off with long waiting lists of hundreds or thousands. When do we expect to overhaul them? It can never happen unless we have a doubling of the expenditure on health for X number of years. Do the witnesses think that is possible? I do not think it is.

To return to the first point, the population is aging but people are now working longer than they ever did before, and they have to do that because of changes in legislation, which were necessary. However, everybody avoids the cohort of new people who have come into the country, of whom there are a very large number. I am sure they are as healthy as the now aging population were when they were younger. Therefore, there is a missing part to the explanation and we are not getting it. I do not know if the witnesses are in a position to be able to give us that information. However, if we are talking about a 30% increase in the health budget, we are talking about €5 billion in a year. I do not think that kind of thing is going to happen, or not easily and not quickly, so we have to find another method. We are still stuck with the allegation that we are paying more for the service than most other OECD countries.

There are places in Australia - the outback, for example - where it is fairly expensive to deliver services over vast areas of territory but people get a service, and it is the same in parts of the United States and in Canada, which are massive countries. This economic notion that has been brought forward over the years, that we will build bigger hospitals in high population locations and will forget about the rest, does not stand up anywhere else except in this country.