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

I thank the Minister of State for coming here today. One of the matters raised by consultant representative bodies when coming before the committee is the lack of training posts. As a result of the loss of experienced medical people to other jurisdictions and the reliance on locums, we now have the potential for a legacy issue as approximately half our non-hospital consultant doctors are not in training posts. We do not have expertise in the pipeline. I am particularly concerned about it because we have said so many times that it is not just money that gets people back but rather conditions. We discussed the children's hospital here last week and we hope it will be the best children's hospital in the world so we can attract the best people to work in it. I have concerns on how we will staff it with respect to junior doctors and training programmes. Is there anything the Minister of State can tell us today that will address the matter so that in 2022 we will have the best doctors to treat our children when this much-needed hospital is eventually built, despite many people's best efforts to not have it built?

The treatment abroad fund is very helpful to people who are waiting a long time for treatment but there are administrative costs borne here in our regular budget. The National Treatment Purchase Fund is separate. Without oversimplifying the matter, it is not as simple as sending a patient abroad and we never see him or her again once he or she is fixed up. There is still an administrative burden here. The information from abroad must be sown into the system. It is a good idea but I get alarmed every year at the increase in budget. It is good because we are treating more people but I would prefer to treat them at home and they should be in our system. There has been a year-on-year increase over the past number of years so how will we try to reverse this so we can have our people treated in our hospitals by our doctors?

With regard to the State Claims Agency, we had the CervicalCheck scandal this year and it had a large cost arising from administration and insurance payouts.

I understand the weight of the claims are predominantly based in the obstetrics and gynaecology area. While it is great to have a large budget of €1 billion or whatever it is, no money will ever pay for a catastrophic incident at birth. While it is great to have the money there, my preference would be to have no budget for claims against the State, just as with the NTPF, because we would not have any claims and we would not send people abroad. As we try to address legacy issues from the recession and the impacts they have had on staff quotas, staff morale and the loss of expertise, how can we get our act together to move out of the recession period and repair our health system to serve people with the benefits of modern medicine, demographic pressures and so on? How will that be managed in the future? I acknowledge that is a broad question.