Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I will do the best I can. We will have the quarterly meeting with the committee next week so there may be some more extensive responses available to the Deputy at that stage and that might provide a better opportunity to put questions to the HSE and so on.

The consultants and skilled staff issue is an important topic that gets a lot of attention and focus in the Department. We want to ensure that, as the Deputy said, when we build the children's hospital, we can address that. I have the same issue in my portfolio in that the new central mental hospital is due to open next year and we want to ensure we have the requisite number of consultants. The Deputy began by asking about training posts. That is something I had occasion to look into recently as well and I am glad that there has been a significant increase in my area in funding next year for higher specialist training that is necessary to work at consultant level. I do not have the numbers to hand but the numbers being trained have increased across the board year on year and more funding will be provided next year again in a number of pinch point areas where there is a deficiency. We are also looking to the challenge whereby consultants can move on after their training and we are competing with the global market and that is linked to terms and conditions. The children's hospital and the central mental hospital in Portrane will be two state-of-the-art environments for people to work in and be part of. That environment is a help.

Significant progress has been made on a number of outstanding issues relating to consultants in the past 12 to 18 months but some issues remain that we would all like addressed and we are trying to get to those remaining issues on a piece by piece basis, notwithstanding what we have achieved in negotiations with consultants on their conditions. The training of advance nurse practitioners, ANPs, across all skill sets is highly important as well. That is a positive development in the health system that offers enormous potential and, again, they work well in my area. They call ANPs physician assistants in the US where there is another level below the consultant level but above hospital doctor level. We have a lot of work to do in Sláintecare to look at identifying the skill set and the skill match. A great deal of work is being looked at in the framework in order that we can meet those demands but that is an ongoing challenge.

I concur with the Deputy on the cross-border scheme. I would prefer if we had the capacity here to treat our own patients but under EU law every EU citizen has a right to travel for healthcare if they so wish, if the treatment they need is not available in their area and we have obligations in that regard. It works both ways. I recall a meeting with the head of the police in Dubai. They are anxious to work with us again as they have been availing of coronary care in Ireland. Any members of the Dubai police force who require coronary care and heart procedures are sent to Ireland. That is obviously not covered by the EU directive because the United Arab Emirates is not in the EU and they are using private hospitals so they are not causing a blockage. People will always travel for healthcare. I would prefer us to have increased capacity but the difficulty is that the money being spent on that scheme could build additional capacity but that lifeline cannot be cut off. It would be illegal to do so. People have to have the right to migrate.