Mr. Simon Nugent:

As has been said, I am the chief executive of the Private Hospitals Association that represents 19 private hospitals located in ten counties located across Ireland. I am joined by my colleague, Mr. Fitzgerald, who is deputy chief executive of one of the association's members, the Beacon Hospital. He has extensive experience in hospital management in both public and private sectors. He will offer his insight into the potential for the future of health care.

Members will have received the association's submission last August. It sets out the extent of acute medical and mental health care provided in private hospitals in Ireland. We employ over 8,000 staff and provide 2,500 beds for patients on an ongoing basis. This enables us to provide, among other things, 250,000 inpatient procedures, 3 million diagnostic tests, over 1 million bed nights to patients and 10% of Ireland's inpatient mental health care annually.

We estimate that 50% of all elective procedures in Ireland last year were performed in our members' hospitals. In addition, half of our hospitals operate either emergency departments or medical assessment units, which in total see more than 1,000 patients each week, admitting at least 250 of them thus providing an estimated 100,000 bed nights of medical care to patients admitted on an emergency basis each year. I have highlighted these numbers to the committee because they illustrate the scale of care provided by private hospitals. Such care, in our absence, would fall upon the State and the public system as an additional burden.

Earlier in 2016, the association made proposals to the Department of Health with the aim of fostering closer partnership between the public and private systems in the coming years. We believe there is scope for closer collaboration on several fronts, including reducing waiting lists, tackling overcrowding in emergency departments, recruiting health care professionals and adopting a strategic approach to capital planning. We are working through several of these ideas with the Department of Health.

One welcome innovation has been the reintroduction of the National Treatment Purchase Fund. While the resources available to be spent in 2017 are relatively modest, PHA members will be able to respond and provide treatment to some of the longest waiting patients on public lists over the coming months. Earlier treatment of those on waiting lists is important for patients but it also brings significant savings to the Exchequer as an increasing complexity of conditions, as they develop, is avoided.

Looking forward, the PHA would encourage the committee to take a whole of system approach to planning the future of health care. It should acknowledge the scope for partnership in delivery between public and private systems and take the following into account: The contribution that private hospitals already make; the modern infrastructure in which we have invested and continue to invest; the highly skilled personnel working in our hospitals; and the capacity we have to work with the public system with hospital groups, community health organisations, etc.

In conclusion, as set out in more detail in our submission, the association recommends that the committee does the following four things. We would like it to acknowledge the mixed nature of health care provision in Ireland and the significant proportion of care delivered by private hospitals. We hope that the committee will offer a strategic vision of health care in Ireland in ten years' time that recognises the benefits of the mixed delivery system and provides a stable environment for investment in the sector. We would encourage the committee to focus on the primary care services, which is something that all of the delegations that have met the committee have emphasised. We want the primary care services, as they develop, to integrate successfully with all of the providers of hospital care. Therefore, there must be a joined up arrangement between primary and continuing care. The association also wants the committee to place an emphasis on health sector recruitment and the need for a sustained focus on attracting nurses, doctors and other clinical specialists to work in Ireland.

We recommend the establishment of an expert skills group on the medical professions which tackles all of this in a holistic way. I know the committee has spoken on several occasions about the importance of e-health and we would like to underline what we see as the importance of investment in e-health as an enabler of truly joined-up health care, facilitating best crossover between different health care providers. Finally, we urge the committee to support closer cooperation on patient care between public and private systems during the transition between now and 2026.

I will hand over to Mr. Fitzgerald.