Brendan Smith (Cavan-Monaghan, Fianna Fail) | Oireachtas source

I welcome our witnesses and compliment CAWT on its work over the years. As Ms Gildernew said, we had engagement with Tom Daly many times. It was always very useful. I do not think I will engage as positively now with him when he is trying to take the Ulster final in Clones, to bring it to a revamped Casement Park. We would have a slight difference of opinion on those issues, but I compliment Mr. Daly and all who have pushed out the CAWT programme so successfully.

CAWT was very fortunate in its place of birth in Ballyconnell. It had a very good start to life in the first place. I just noticed it has quite a disparate number of groups to work with in Northern Ireland. We often think our health service is not consolidated enough but when I see the number of different partners and providers CAWT has to engage with in Northern Ireland, I am sure it is not that easy.

The Minister for Public Expenditure and Reform has indicated to us that he expects to sign off on the PEACE PLUS programme in the not-too-distant future. In our parliamentary party, as Senator Blaney could attest to, we have been urging him to move it along as quickly as possible. No obstacles are foreseen at this stage to signing off on it. We would be very glad to do whatever we can do to support the programmes CAWT put in for consideration because all of us have experience of the good use to which it has put relatively small money in the past. It influences all of our opinions.

Deputy Conway-Walsh touched on some skills and medical shortages. We also know of the shortages of other clinicians, therapists and nurses. Does CAWT have any particular project in which it would train people specifically for the Border counties in collaboration with the institutes of technologies and the general hospitals? I know that in my local hospital, Cavan general hospital, we have nurses who are doing their nursing degree in Dundalk Institute of Technology. I assume it is the same in Sligo.

Could there be a specific project to try to train more people? I hope more people would take up jobs in the area where they are trained. It is not easy to attract young clinicians to more remote areas. I will go back to the GPs as well. It is generally accepted that the age profile of many of our GPs in rural Ireland is high, unfortunately, and it will not be easy to get replacements. From a number of incidences I have dealt with in my constituency, I know the HSE has struggled to try to get people even to apply for some vacancies at times.

We have two different health systems, North and South. Is there any way consideration could be given to some cross-Border GP practices? In remote parts of the area that I represent, going in to Mr. McCallion's area in north Leitrim, Cavan and Fermanagh, there are small GP practices on both sides of the Border. When the practitioner retires, it is extremely difficult to get a new incumbent. It might be worth giving some thought to practices being merged or amalgamated to some extent. I appreciate the structural difficulties there are with two different systems, but we have to think outside the box to ensure we have reasonable access for people to GP care in rural areas. It is extremely important.

We live in an era now, with a particular emphasis by An Taoiseach and the Government on the shared island concept, when we have to see more working on a cross-Border basis. We have to see more collaboration. Over the years, in the past, the hospital in Omagh used to provide EMT services to Cavan and Monaghan. A limited service is now provided by Coleraine. I do not know if it is in CAWT's remit but we have to have more provision of acute services on the basis of collaboration.

When there was a big challenge in regard to replacing the Erne hospital in Enniskillen and Omagh, I remember at the time, the thinking was that the very substantial south west hospital would collaborate with Sligo and Cavan general hospital. To my knowledge, what we want has never been achieved and we have to have a focus on delivering services, such as specialties, on a cross-Border basis. We have to try to move out whatever blockages there are. If I have a constituent in Cavan or Monaghan, they want to get the service as quickly as possible, as I am sure our neighbours north of the Border do.

Will the witnesses give some update on whether any progress is being made in that respect? I know they deliver services, but I am sure they have an input in policy up the line at Department and Government level. Is any thinking going in intensifying co-operation and the delivery of services at general hospitals on either side of the Border, to service the needs of the people on a cross-Border basis, in particular specialties?

I very much welcome the work CAWT does. As a public representative who has been familiar with that agreement from its inception, I would be very glad to support its work and I sincerely hope the programme it puts forward to the special European Union programmes body that it meets with approval.