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

I welcome the Minister, Minister of State and their teams. I strongly support the Minister's comments on what happened last Thursday. The remedy some people have to address the issues which they see a need to address is starkly at variance with the national image heretofore. As a nation, we became known as the island of the welcomes. That is in stark contrast to what we saw on our streets in our city just a week ago. There is no excuse for what happened or for attacks on people going about their business, whatever their race, creed or colour, in this or any country. It is the most basic form of hatred known to democracies. Some say there was cause and that people had enough or whatever. We do not want to degenerate into that kind of atmosphere as a means of promoting ourselves on the international stage and encouraging people to come here to live, work, give their expertise and services. If we want to continue international investment and foreign direct investment here, that is not the kind of message that needs to go out. I strongly support the Minister's views on that. I hope the situation that arose will not arise again ever.

On the Estimates, I asked why were we coming in so quickly with the Supplementary Estimate. The Minister pointed out the reasons. However, it is time we got fairly accurate Estimates of proposed expenditure before we go to budget - not the day or week before or anything like that. I know the Opposition will seek to exploit the situation and blame the Government but this is too serious an issue to play around with. There have been huge demands and strains on our health and emergency services over the past three or four years. The people on the front line in the health services made a huge commitment to the demand as it arose and went above and beyond the call of duty. We need to record that and point it out. Concerning population growth, we must be able to reasonably accurately identify population trends. We should be able to do it in advance of most situations and have it reflected in our schools, health services and anywhere there is a demand for services. It is not rocket science to identify trends in any of those areas. While there is an element of it being a demand-led service, it is also a necessary service and important for the support of the economy and the people living and working here.

There is a €75 million provision for medical negligence. Is there any reason for that? Does it represent a growth above and beyond expectations? Is it in line with expectations? Is it because of an increase in the number of claims or the value of settlements awarded, particularly arising due to catastrophic birth injury? Is there a noticeable trend, with a view to implementing measures to obviate the likelihood of that continuing? I would like at some stage to follow up on the average settlement; I do not want to know anybody's business. What are the ingredients under that heading such as legal costs and so on? What were the surrounding causes? As public representatives, we are all familiar with situations in the past concerning difficulties from time to time in maternity hospitals. We need to know a little more about the trends and how to isolate problems causing difficulties from the perspective of budgeting and the health of women and babies.

Another area is reimbursement services. I mentioned at the meeting with the HSE that there will be incidents in hospitals, which we accept, but the trend must go in the right direction. I was critical in some sense of medical cards, which should be issued to victims of hospital incidents beyond their control, in order to identify them and ensure some responsibility is taken regardless of legal actions or anything else. Simply issuing a medical card could help to alleviate suffering and trauma for patients. It is not for life, it is for now. It must be dealt with so patients and their families can see a response to their particular situations and not be treated as if they were a general, run-of-the-mill inquiry. There are particular circumstances that apply to them. I would like to see them addressed.

There was a huge increase in staff in the HSE, which was needed in any event. It should not go out from here that it is vastly inferior to demand; it is not. There is a massive budget for health. We were criticised previously by economists for allegedly allowing the budget to escalate, or as they said, go "out of control". I do not agree. The Department of Health must respond to the health needs and demands of the population. While we accept a certain amount of that has to be demand-led, and there will be a bit of waver from time to time between the posts, as it were, we must expect that we keep to the best projections possible and that the people who do the projections are well-rounded in what is required.

We must not allow a situation whereby the public might see that the Department and the HSE are at sea, do not know what they are doing, going from day to day on the basis of this being demand-led and not getting to grips with the situation. I know that that is in hand and that it is a difficult job to weave between the posts of the necessity to respond to the demand and, at the same, to recognise that it is not an unlimited budget that anybody or everybody has to bear.

Those are my opening remarks.