John Brassil (Kerry, Fianna Fail)
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I congratulate Deputy Shortall on her appointment and I look forward to working with her. I am qualified in the pharmacy area and I have worked in it for the past number of years, so I have a specific interest in primary care. I would probably like to see the committee break up what we should deal with and try to categorise primary care, accident and emergency departments, elective surgery, step-down facilities, community care, etc. Perhaps we should try to categorise each section that we would like to examine in detail so as to see how we can build our strategy around them.

As other speakers have noted, there are numerous reports out there. I have printed what we have been sent by e-mail and I have run out of paper several times. There is a primary care report by Indecon that is quite thick.

I think all the reports would have common suggestions on how to tackle the issues in primary care. It would be well worthwhile for the committee to resource people to analyse and come up with the common themes of all these reports. If a team of experts has gone to the trouble of producing a very detailed report with the same suggestions, having taken cognisance of it as a group, we should bring forward the proposals for action, instead of a further report. That is what we should consider.

One hears very good reports of what works in certain hospitals. For example, for many years, one has been hearing very good reports of the accident and emergency unit in St. Luke's Hospital, Kilkenny. If that is the case, why can we not replicate that model in other hospitals? We should look at the elements of the health system that are working and at ways of replicating what works in other areas. That is the model we should look at. Yesterday in the Dáil I spoke about the lack of an acute stroke unit in University Hospital Kerry during the Topical Issues debate. I had read a comparative report on the service in Kilkenny, Waterford and Kerry. The results were startling. It was frighting to compare the results from an acute stroke unit that is working properly with one that does not. The very simple solution is to get an acute stroke unit working in all hospitals which deal with strokes. That does not happen at present. Sometimes we over-complicate the issues instead of following a strategy of simplifying things and replicating models that work.

I agree with Deputy Clare Daly that for me and many others developing a strategy is new idea, whether it is in the area of health, education or whatever. It would be helpful if we could get advice on formulating strategy, so that we go down the right road from the start instead of finding out that we have spent months on work that did not bring us forward.