James O'Connor (Cork East, Fianna Fail) | Oireachtas source

I thank the witnesses for attending. There are many different areas that we could focus on. One of the things that really jumps out at me is the climb in expenditure from 2019 to 2023. Obviously, that is taking Covid into account but it seems the expenditure has not dropped back. To give context to my comments, we are looking at the figures coming from south of €20 billion, at approximately €17 billion in 2019, and climbing to over €25 billion now.

One of the things I want to feed back to the witnesses, as somebody who has been elected to the Dáil for four and a half years in a rural constituency, is that we know that 1.6 million of Ireland's population are deemed to live in rural areas. The lack of access to GP services is extraordinarily bad and it is getting worse. Lack of access to out-of-hours services is at crisis level. I do not want to get too parochial but I can speak to my constituency because I know about it from meeting constituents. When people want to see a GP but perhaps cannot do so or they have to wait for a period, their health worsens. That potentially requires an emergency solution, with people going to an emergency department. The consequence is that they may end up on a hospital bed or on a trolley. This clogs up our hospital system.

I have raised this before. It is staggering that 25% of GPs are now over the age of 60, if I am not mistaken. What has Mr. Gloster done in the past years in his role to address this? Where are we with it? The expenditure in the HSE is climbing rapidly. We are lucky to live in a sound economy but I am fearful of what may happen if circumstances change internationally. Can we sustain paying Mr. Gloster's organisation such a sum of money annually?