Lisa Chambers (Fianna Fail) | Oireachtas source

I thank the witnesses. I have a couple of questions, since I think all the members have spoken at this stage. It is nice to hear praise for Catherine Donohoe going in both directions at both sessions. There seems to be a good relationship between the hospitals, PDFORRA and the health service, which is good because that benefits the patient. Mr. Bright is right that if we were to discuss recruitment and retention in the Defence Forces, we would be here all day and night and well into next week too. That is probably a topic for another day and another committee. He is right that anything we can do to keep people in their jobs and serving is worthwhile. PMAS is clearly doing that. It has directly helped nearly 260 people to stay in a job, which is a fantastic achievement for a scheme that is in its infancy. It has gone from strength to strength and has been a significant success. I give credit to the witnesses for having the ingenuity, foresight and vision to set it up and make it a success. These things might look easy when they are up and running but actually getting there is a difficult task. Finding a way, getting on with the job and doing it for themselves is typical of the Defence Forces, because if they waited for the State to do it, they would wait for a long time. It is indicative of the mentality within the Defence Forces of getting the job done, which is a credit to everybody involved.

My first question is for PDFORRA. It meets the cost of the shortfall. What has been its experience of what the State is providing through reimbursement compared with the actual cost? Is it finding that to be a difficulty or is that manageable for the organisation? We have heard loud and clear about the need for certainty and we impressed on the HSE in the last session that we really needed to know about this. It would be good to get a solution well in advance, unlike everything else related to Brexit that has run to a cliff-edge deadline, so that we can flag it to all stakeholders and know what is coming down the tracks after this 12-month sticking plaster. Why can we not get it done early rather than waiting to the last minute? The witnesses mentioned that there was a limit to how much credit PDFORRA can secure. Will they explain why that limit is there? Is it self-imposed or is it imposed in conjunction with the credit union it is working with? Is that having a major impact on the people in the scheme waiting to get healthcare?

I was struck by the last part of Mr. Regan's opening statement in which he talked about the impact of patients waiting for longer than they should to get treatment. He referred to the impact of waiting for three years for a hip replacement. He touched on muscle decay, which is irreversible. It is unacceptable that our health service would leave people in that situation where they have had irreversible damage done because they have had to wait. By the time the patient gets to the witnesses, what has prevented them from going sooner? Have they not been able to afford to get the money together? Were they giving the health service in the Republic a chance to look after them? Why were patients waiting for so long before seeking out that help? Have the witnesses identified certain barriers that the committee needs to address in its report?

While I know that Mr. Regan is concerned that too many changes might push this over the edge, one of the points that I and others made to the HSE in the last session was that now we have an opportunity, we are not confined by the directive and we have an opportunity to reimagine all-island access to healthcare and maybe make some improvements and remove some of the barriers that are clearly there. The fact that we have PMAS, people getting buses to Northern Ireland and the demand for the service is because there are barriers to healthcare here in the Republic. What barriers have the witnesses seen to people accessing healthcare at their facility?