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

I believe personally, politically and professionally that if we always do what we always did, we will always get what we always got. If we continue to keep hiring and throwing more money at the problem, we will not fix the healthcare system and I am not suggesting the Chairman is proposing we do that. The other extreme is not to hire any more staff so there is a balance to be struck between those two positions. I spoke earlier about the constant tension between the desire to continue to recruit and looking at what we have done. It is about reorganising healthcare delivery and the budgets. We are here as politicians and one day we are giving out about an overrun and the next, we will give out that the service is not there and so on. How do we fix that? It is about structural reform. The regional integrated care organisations, RICOs, are an important development as opposed to the community healthcare organisations, CHOs, because it was maddening to see people in the community considered not to be part of the problem if they were on a trolley or on a hospital bed for an extra week. That did not bother the people in the community who were in charge of home help in the slightest because if one person was in the hospital, that was one less person for them to take care of. That siloing we did in healthcare was not helpful with budgeting. We can continue with additional recruitment in acute healthcare but we could look at more proactive ways and means of avoiding admissions to acute healthcare. Perhaps there should be more recruitment for community healthcare. Recruitment in and of itself is a solution but it is not the solution to everything. Putting a cap on it is about getting people to work within the budget they have so they cannot have an open-ended budget. Otherwise, we will be back here again next year looking for an €800 million Supplementary Estimate