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

I agree with the Deputy. The politics is one side of it. To use a medical analogy: we can treat the symptom or treat the cause. Much of the time our energy and money is focused on treating the symptoms and not the cause. The Deputy referred to access to care. In 2020, we will to publish an access plan for unscheduled care looking at how we can deal with this issue.

Talking about the politics of it and politicians, a few months ago a lady approached me. She said she had been out of work for a year and a half because of an injured shoulder and was now fit to go back to work. She needed to be signed back on by her consultant. She rang the consultant's office to find out if she could see him. He told her he would see her in 2021. She told me she did not want to draw disability allowance for the next 18 months or two years, while waiting to see a consultant for five minutes to sign her back to work. She asked if I, as a Minister of State, could so anything for her.

I wrote to the consultant and asked if there was any possibility he could see this lady for five minutes. He wrote back to me saying that he would not discuss any of his patients with me and suggested it was more in my line, as a Minister of State, to provide more money. That shows what happens when people look to politics to solve these problems. There are structural issues. I tell that story for two reasons. One is to illustrate the Deputy's point about the politics of it. More important, it is to look at how we fix the structure.

In one particular discipline in the south of the country, I have sought information from the HSE through the Secretary General of my Department on the time each of the consultants in this discipline is giving to private and public practice. There are enormous anomalies in the one I am looking at. These consultants were contracted by the State and are supposed to be spending a certain amount of their time delivering to the public. These are issues affecting waiting lists because they are all on the public side. Obviously, on the private side there is no waiting list and a patient can be rushed through and there are incentives for people. I am not saying that is widespread, but I have come across one area where it is certainly an issue and I am doing further investigating to try to get to the bottom of it where there is a particularly long waiting list.

Structural reforms like that will fix it as well as just policy and, as the Deputy would suggest himself, not soundbites.