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

I welcome our guests and thank them for the information. I do not want to go over the earlier session but it is important to recognise that we all need to get to a place where we can rely on the system, and a system that works. It is about patients' health and the health of the community. The committee has been told at these meetings that Ireland has one of the most expensive health systems in the world. I do not know if that statement is true but it may be true in some respects.

For my sins, I was an Opposition health spokesperson in the past. There is a tendency nowadays to blame the Government for everything. That was not the case with me because I did not engage in that practice when I was in that particular role. It is an easy option to say that because the weather is bad today and has been for the past year or so, the Government can in some way be blamed for that or that every issue that affects the public in a negative way can be attributed to a politician or politicians.

That said, we deserve to have a high quality of service and good working conditions for those who are employed in the health services because of the nature of the service. When something goes wrong or when an accident takes place in a hospital or accident and emergency department and people are not attended to in the way they feel they should be attended to, we have to ask questions. This is in order to protect the quality and integrity of the service, the individuals working in the services and the patients.

The recruitment embargo has been mentioned more than once in the context of other issues. Do the witnesses accept that, according to the Minister for Finance, there was runaway spending taking place in some areas of the Department of Health? This was brought to the attention of the Minister. How should that be dealt with? Was the budget too low in the first place and should there be a higher budget? Do we need to look at the budgetary surplus? This question has come up a few times in the recent past. Everybody sees a budgetary surplus as something we should aspire to spend but we have to be careful. Ten or 12 years ago, the whole financial system collapsed and everybody in the health system, the education system and the general administration running the country had to take a whacking cut, left, right and centre. That was not determined by institutions in Ireland but by the International Monetary Fund, which began to fund and support us. It was a case of either doing that and voluntarily operating it or having it done for us in an arbitrary fashion, which would have been much more hurtful. The difference was between making a cut of 25% or 30% as opposed to having a 60% cut made. There was no money. In the event that there had been a 60% cut, there would have been real devastation. In some countries in Europe, there was no money in the ATM machines for a good part of the day on any particular day. I know that because I experienced it myself. Are the witnesses conscious that we need to balance our requirements insofar as meeting the needs of the people?

It is correct that we need 5,000 extra beds but I was a member of a health board when we were told we needed 5,000 fewer beds. Experts came in and told us the system was all wrong and in future inpatient attendances would be for a couple of hours and then off people would go. It is not possible to do it that way all the time. There are certain situations that need different types of treatment.

Population growth and people living longer are to be celebrated, and rightly so, but do our health services recognise that there are situations within the system that should not happen, even in cases where services are stretched and there is overcrowding?

Members visited University Hospital Limerick in the past few weeks. It is a good hospital and everything is run very well, with the one exception that two accident and emergency departments in the region were closed down and patients were transferred to the ED in UHL, which is under construction. I do not know who made that decision to close down the EDs in Nenagh and Ennis. The fact is it is not possible to turn over the number of patients now in need of attention in UHL on the basis of that situation, which was unfortunately presented to the staff who are now stuck with it. Somebody made the decision but nobody came forward and told us that they had made that decision on the basis of expert knowledge and information available to them. The consequences of those decisions are being lived with still. That is the first comment I wanted to make. Perhaps some of the witnesses will respond to it.

It is not possible to replicate the conditions on Bondi Beach and various other places given the kind of weather this country has had for the past year and a half. It was just unfortunate. The Government was working on that but failed to deliver the same conditions.

What do the witnesses say to those who say our health services are costing more than comparable health services elsewhere?