Leo Varadkar (Dublin West, Fine Gael)
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Not that I am aware of, Jerry. I do lose time from time to time, so maybe I have had a pacemaker put in. It is Jerry and the pacemakers.

Alcohol, obesity, smoking and inactivity contribute to a significant number of problems in our emergency departments and I am very keen to start doing things in that space. I know members are engaged in pre-legislative scrutiny of the public health (alcohol) Bill and I welcome their input. Nothing is set in stone and I am very keen to hear members' views as to how the Bill might be improved.

Senator Crown had a query regarding maternity services. We have been paying a great deal of attention to maternity services in the past year or two. It is important to reiterate that maternity services in Ireland are safe. In Ireland some 60,000 women are pregnant at present, and for many this is their first pregnancy. These women do not need to be worried unnecessarily about concerns about our maternity services. That is evidenced by the fact that our maternal and perinatal mortality rates are on a par with anywhere in the western world. We have more consultant obstetricians and midwives than ever before. Although we do not have enough of either, we have more than ever before at a time when our birth rate is falling, not increasing. That is not to say that mistakes are not made. Medicine and midwifery are judgment calls. One will visit a patient, examine and conduct investigations, talk to her, put all the information together and make a decision. Sometimes the decisions that are made are wrong, but that does not mean that the standard of care is poor or that doctors or midwives are not competent. Sometimes there is malpractice, and when it occurs, it is important that there is open disclosure. It is important that hospital management, doctors, nurses and midwives are honest with patients and their families about what happened and engage in full and open disclosure. It really bothers me that this is not always the case, even though that is the policy. It will become the law in the future if I have anything to do with it.

Senator Crown has suggested that midwifery services be entirely consultant provided. I do not agree with that. The Senator and members will agree that we always need doctors in training but perhaps the ratio of doctors in training to the number of consultants is wrong. Perhaps we need more consultants and fewer doctors in training, but one always needs a stream of doctors in training coming through in order that we have consultants. We have a very good community midwifery service and some very good midwife-led units in the country. There are many models in other parts of the world, from Finland to Holland, where many of the maternity services are midwife-led and not consultant-led. We are working on a maternity strategy this year and I want to have it completed this year. Some aspects of it may turn out to be politically controversial, but I am not bothered about that as I am more concerned about high quality maternity services than votes. Part of what will have to be considered in the formulation of the strategy is the appropriate ratio of consultants to doctors in training and whether there is scope for expanding our midwifery-led services as well. Perhaps the consultant-led medical model is not the correct model for all maternity services in Ireland. I cannot answer the question regarding patients and perhaps a member from the HSE can do that.

I agree with Senator Crown's comments on the retirement age of 65 years. The new contracts do not require that doctors retire at 65. However, some existing contracts do and a contract is a contract. I have no personal objection with doctors staying beyond the age of 65 years. Quite frankly we need them, so if they are willing to stay on, we should be very open to it.

I read the statement and I heard Mr. O'Brien's comments on my way in on the issue of Soliris and it is very clear that any criticism was directed at the company and absolutely nobody on this side of the table or anyone under any circumstances wants to be or intends to be critical of patients. We will be critical of vested interests on occasions where it is necessary.