Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I apologise for being late. I had another meeting which went on.

I sat on the Sláintecare committee. Although this issue was part of it, I felt it was ideological in terms of the proposals for how it should be done. I get what Dr. de Buitléir is saying in that staff numbers are the same, as is the number of sick people who require care. His response to Senator Colm Burke was that it was just about moving people to receive treatment in the public system.

On the 39-hour contract, the lack of autonomy is an issue for consultants. I am not sure if the research and development element is an issue in the context of the 39-hour week. Obviously, their contracts would have to have on-call and other activities sewn into them. On restricting someone at the top of his or her game professionally to a 40-hour week, is it anyone's business if they want to work 15 hours somewhere else? I am not saying they should or should not, but I wonder if this is the way to bring the profession with us.

We have heard in the last couple of sittings of the committee that there is a very significant draw from the public into the private sector. Senator Colm Burke referenced the situation in Cork where 12 or 14 consultants have left Cork University Hospital to move to the Bon Secours Hospital. A number of dermatologists have left Beaumont Hospital, while an emergency department consultant recently left Tallaght Hospital to move to the Beacon Hospital. With this in front of us, how do we pull them back? Is the stick rather than the carrot approach the way to do it? No amount of discussion here will make a consultant return from a private hospital to the public system. With all the ideology in the world, we still need consultants to deliver care. I am not sure how what is in front of me shows that is possible.

I refer to the figure of €650 million a year and Dr. de Buitléir saying it is going up to that amount. I sat on the Sláintecare committee and get that it is building up to that amount. Every year there is an increase in the health budget and the money seems to be absorbed into a bottomless pit. My concern is that the €650 million will be layered constantly into the overall budget with no improvements in service in return. It might be €250 million one year and then €650 million, but I cannot see how we can show that money will improve services to the extent that it will encourage people to stop paying for private health insurance because they are happy with the public system. Am I wrong in saying that?