Professor Matthew Sadlier:

It is a grade of junior doctor. It is often the doctor who people will first see when they come into a hospital. We were able to see 16 or 17 patients a night because medicine was less complicated. There was less to do. If people came in with a stroke, the best practice management at the time was for them to get aspirin and then you waited until they did rehabilitation. There was not an ability worldwide to intervene. Now there is an ability to intervene. If people come in now with a stroke, they need to get a CT scan as soon as possible to see if it is a bleed or a clot. If it is a clot, we now have therapies that we are able to try to dissolve the clot to allow the blood to flow back to the brain to stop brain tissue from dying off. There are similar interventions with heart disease and other medical complications. Many years ago, we were able to plug through, but for junior doctors today, medicine has become so much more complicated. Each patient is taking longer than they would have in the past because we are able to do much more.

As well as that, the hospital we would have built when I started working, and I am sure Dr. Gilligan would have similar experiences, would have had ten-bed wards, such as in Limerick when I started working. I do not know if patients now would be happy to sit in a room with nine other people and one toilet. Not only that, but when we build hospitals infection control has become much more important, so the area in square metres per patient in new-build hospitals is now much higher. The number of bathrooms and toilets per patient is now much higher. It is an expensive business. If you want patients to get the best treatment, unfortunately or fortunately, depending on your perspective, it costs a significant amount. We need to start a hospital-building programme today and we need to roll that on for a long time.