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

Waiting lists in general have consumed much of our time. How can the waiting lists be dealt with? It is not rocket science. If we have a waiting list of 1,000, we should be able to figure out how long it will take to deal with it. This is where the planning comes in. Where are the deficiencies that prevent us dealing with that waiting list now? If we cannot deal with that waiting list within a specified period, we should know the specified period within which it should be dealt with and we can then do the budget again. If we cannot do both and identify exactly what is required, the waiting lists will go on forever. If a waiting list is half a mile long this year, it will be two miles long next year because we will have not shortened it. The only way to deal with that is to attack it from all ends together. If that means reverting to the treatment purchase scheme or the private sector, we need to deal with it. There is no good talking about it.

I recently came across a case where the patient was due to come back in two or three years because the condition was supposedly controllable or containable. It was not and I was proved right. If we are telling patients things like that, we are reducing public confidence in the system. I do not attribute blame to anybody in particular, but we all need to recognise it. It is no good talking around the subject; we need to deal with the subject.

Just as in the PC sum to deal with unforeseen issues that come up during the year that we have to deal with - we have to deal with emergencies anyway - we should also draw up a plan to tackle the logjams. It is a farce to have people hanging around in emergency departments all day long and the following day. We have older people sitting on trolleys for two or three days. We should not be dealing with that at all. It is demoralising. Why do we not have a bed to put them into?

Earlier today we had a discussion with representatives from Fórsa on step-down beds. There are step-down beds for women in St. Brigid's Hospital in Crooksling and the Government is closing the place on the basis that the facilities there are old. They are not old; all they need is ongoing maintenance. Such facilities could come on-stream to relieve the pressure we are now facing.

We need to look again at how we are doing it. If we put one doctor into a hospital emergency department and leave him there for three or four days, I guarantee that he will be out the door and down the road after a week. It is not possible for one person to deal with full weight of the demand at any given time. We need a relief system and we must be prepared to recognise that that will arise.

People will claim that I am speaking like an Opposition Member. I am speaking as I have always spoken, as a member of any health committee or body; I have been on a few of them over the years. There is no difficulty dealing with the political element, which means nothing in terms of a contribution to alleviating the problems that now assail the health services. To lift that siege, we need to be able to reassure people with a plan for reducing waiting lists in the coming year.

The IFAC needs to know that as well. I do not propose to take on the council because I know where we went in the past. However, it needs to take into account those areas of current expenditure where we need to deal with the size of the problem as it arises. The result is we do not do anything about it in which case the service becomes run down.

Ireland is the third most expensive of the OECD countries and 27th in public satisfaction ratings. There is something wrong there. I do not know what the problem is. I am not an expert in these issues. I do not need to be an expert, nor does anybody else. However, somebody somehow and somewhere needs to say, "Okay, we're going to merge these two areas. We are going to deal with them. We are going to identify the contributory causes." We are continuously told about the Dutch and Swedish models. They do not work, for God's sake; they have the same problems.

It all comes back to identifying the scale of the issue in a service that cannot be postponed forever. If it was a road building project, it could be postponed, but when somebody's health is at issue, it cannot be postponed. Doing nothing scares the public and demoralises those involved in the service. It avoids facing the decision that has to be taken eventually to deal with the patient.