Róisín Shortall (Dublin North West, Social Democrats)
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I will pick up on that last point. It is important that we get the full picture. I address this to Deputy Lahart too. We all know that the population is growing and ageing, and the level of dependency is increasing. It is important to bear in mind that the budget allocation to help last year was insufficient. That is not just me saying that; the Irish Fiscal Advisory Council said it when it, unusually, made an intervention. It normally gives out about spending too much money. It stated there was not sufficient funding in the healthcare budget to meet the demographic changes. That was an objective assessment. We started from a situation last year where there was not sufficient allocation of resources or posts. That has a knock-on effect. There is much talk about these 28,000 additional staff. That is only meaningful if you are aware of the base number. What is that working off? Is it a big increase or small increase? That is why it is so important to have objective ratios and safe staffing levels that apply. That is needed right across the board.

I am disappointed and concerned to hear that relations have broken down to the extent they have within the HSE. I am disappointed with the new regime that we are at the point where the witnesses, as key people in the organisation, cannot get access to basic data. If we cannot agree on the facts of the matter and we do not have access to that data, it is all smoke and mirrors after that. I would have thought at this stage, with the development of industrial relations, HR approaches and so on, that there would at least be honesty and openness about the facts of the situation. I do not accept the data not being available. Many of us have come across this over the years. We have often been told in replies to parliamentary questions that the data is not collected in a manner that allows an answer to the question. If we then pursue it, the HSE can collect the data.

The data is there, as the representatives said. It may be broken down by line CHOs or local health offices, but it is a matter of somebody having the time and being allocated to assemble all of that and give national figures. The data is there; it is just that the HSE has come up with a response to give to Fórsa that is entirely unsatisfactory. The idea that a key union representing healthcare workers has to go to the bother of requesting an FOI speaks to poor relations within the health service, and it is a key responsibility of senior management to ensure modern systems are in place to consult all the partners in the health service. It is concerning that this is not the case, and it seems the communication is very poor.

The witnesses made the point about the productivity and savings task force very well. It is not only that there is the potential for vested interests to be at play there; there is also a certain mindset. I would venture that most, if not all, members of that task force were not dependent on the public health service. That is probably the likelihood. They may have very little experience of it. There is a mindset, among a lot of people at political level but certainly at the level of consultancies and management bodies, that the private sector is better and more efficient but we know that is not the case. There is a lot of concern about what is happening in the health service at the moment such that the tendency is to outsource. We can reach a tipping point if we outsource so much that there can sometimes be no going back from that. Moreover, it forces trained professionals to go to the private sector or agencies, if that is where the jobs are, and it is self-fulfilling. We are at a dangerous point in the health service because of the extent of outsourcing and privatisation, which, of course, is about extracting wealth from the health service. We should stop that and take steps to ensure that tendency will not continue.

Turning to safe staffing levels, nurses have those to a certain extent, although they are problematic as well, as we mentioned earlier. We do not have full disclosure of the staffing levels among nurses. What is the experience of establishing safe staffing levels in other sectors within the health service? Is there an example of a country or countries that do that well? Could that approach be adopted within a reasonable time?