Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I thank the Minister, the Ministers of State and the delegation from the HSE. I have a few questions so I ask the Chairman for his indulgence. First, we discussed this issue previously and Mr. Woods will remember the discussion about the 107 nurses required in accident and emergency departments. I refer to an agreement reached between the HSE and the Irish Nurses and Midwives Organisation, INMO, and SIPTU last August on a jointly agreed review. At the time, Mr. Woods was fairly clear in telling us, to the shock of the unions, that the specialist ring-fenced funding for the 107 nurses needed to cope with the people on trolleys in accident and emergency departments, which all the witnesses say they do not want but which keeps happening so there is a need to treat them, was not in the HSE budgets. When I asked the HSE about that they said that the Department of Health had not provided for those. I do not want to put words in anyone's mouth, and Mr. Woods can refresh my memory if I am wrong, but could we find out what is happening with regard to those 107 nurses? I know the INMO wants to see those nurses recruited, as does any poor soul on a trolley in an accident and emergency department.

Second, I refer to something not in the statements provided, namely, the stretch targets, which we have discussed. I cannot see any scenario whereby that does not put pressure on hospital managers to bring in patients from the private sector because they are a target. That is Mr. Woods's word, not mine. If something is a target, it has to be achieved. Mr. Woods has set targets. He has also set what he described as stretch targets, which I assume is whatever the target was last year in addition to additional ones, for private patients being treated in our public hospitals, presumably at the expense of our public patients although Mr. Woods can correct me if I am wrong on that.

With regard to e-health and IT, one of the answers given to a question I submitted states that there is a need to recruit additional resources and that this requires departmental approval and Department of Public Expenditure and Reform, DPER, sanction. What amount of additional resources does it require? When was the approval from DPER sought? What was the answer? If it has not been sought, why not? This is supposed to be a priority. We could sit here all day and tell each other about the wonderful benefits of improving IT systems, and none of us would disagree. That might be a very pleasant conversation but given that we all know we have to go down that road, when will the decision be taken, if it has not been taken already, to seek the sanction from DPER?

In response to the same question Mr. Woods said that the waiting list action plans will not specifically incorporate technology supports but that the Minister is open to evaluating new approaches and that he will ask the National Treatment Purchase Fund, NTPF, to lead a project team to undertake such a feasibility study and report to him within six months. That is great, but I put it to the Minister that there is no time like the present so we might move on that. It is one of those fantastic subjects on which we all agree there is a need to move on it. I wonder why we have not done so.

I will not bore the witnesses with my views on the NTPF because they know them but it appears from reading the answers to the questions I submitted that the NTPF will be reviewing itself in terms of its performance, targets and so on.

When I asked questions about the National Treatment Purchase Fund, NTPF, previously I was told that a robust monitoring framework would be put in place. My view of such a framework is one that would have external oversight. However, from my reading of the answers that have been given to questions, and I am open to correction on this, it appears the NTPF will be reviewing itself. One does not need to be a genius to figure that one out. If we are all reviewing ourselves we will all do terribly well. Will Mr. O'Brien outline what checks and balances in terms of targets, monitoring and evaluation of the NTPF are in place, given a considerable amount of public money has been invested in it?

With regard to commitment that children in receipt of domiciliary care allowance will be awarded a medical card, according to the answers I have received, the extent of this initiative is to be reviewed. The programme for Government indicates that 10,000 children will benefit from this initiative. We submitted a parliamentary question on this initiative and costed it prior to the last budget. We came up with a figure of €17 million to cover the cost of it. The HSE obviously did some work on it, because it put a figure of €10 million for this in its budget. What is the latest delay on the implementation of this initiative? There is not a day goes by that at least one family does not contact me directly or my office in Swords to ask when this will be introduced. It must be one of the most announced Government measures ever. It is last July since I tabled a cross-party motion on this measure, which was accepted by everybody. No barriers are being put up to this by any Deputies or Senators. We all want to see it introduced. Yet when Mr. O'Brienresponded to a question I asked, we learned that there will be another review and assessment and further delay on introducing this measure.

I refer to a question that was answered directly to me with regard to the 20-week anomaly scans. I apologise for having so many questions but there were plenty in the submissions. Louise Kenny from the Cork University Maternity Hospital appeared before this committee last week and she made a very clear statement about the need for the 20-week anomaly scans in terms of the risk to children and the risk to women, both to their health and to exposure to unnecessary interventions and procedures. These are screening scans, so they are essential. I asked on a few occasions when these scans will be available. Can the witnesses put a date on it? If they have not set a target for this, I strongly suggest they do so. When will every woman in Ireland who wishes to be able to access that scan, or when can they ensure that the scans will be offered on a routine basis to women - as they are in most developed countries - and available in all of the 19 sites? I have asked about this a few times. It is not something we need to review.There is a general acceptance among health professionals that these scans are necessary. When we will see them being made available?

Mr. O'Brien got a big clap on the back for money management. Does he think there will be a budget deficit in the HSE by the middle of the year? Does he foresee there being a financial overrun by the end of this year? I am interested to know if the HSE has a sufficient budget. I put this question in the context of people being surprised by the outbreak of flu. In the context of how Mr. O'Brien will organise the management of the money for the remainder of the year, does the HSE have a sufficient allocation?

In response to a question I asked, Mr. O'Brien stated that the waiting list action plans will be available by the end of February. It is now 22 February and we are six days away from that date. These are a series of plans. Are they all being saved for the big day or has Mr. OBrien received them in stages? Has he any information on the waiting list action plans that he might be able to share with us now? If not, perhaps he could give a commitment to share those on the last day of February when they will all be magically received.