Bertie Ahern (Dublin Central, Fianna Fail)

Historically, the argument has been that we have provided very good medical consultants. A number of negotiations have been held as far back as 1974 to try to change that. The late Brendan Corish tried that and totally failed. Charles Haughey made contracts in 1979 and Deputy Noonan gave further concessions. Consultants have extremely strongly based contracts. The Tánaiste set out her position in negotiations to try to make changes and amendments to that. Without losing the professionalism we have we could make a number of changes for new posts. We would like to try to get on with those negotiations and we would like the consultants' associations to work with us to make these changes, as we would also like other sectors in the health service to work to make these changes.

In the past the argument was about resources but this is not about resources. Neither is it about staff numbers. It is about how we manage the health care system on the accident and emergency side. It is not a case of the Government issuing a diktat and then it all just happens. The Government is not saying it is the responsibility of the HSE and we have nothing to do with it. We spend an enormous amount of time, collectively, working on this issue which is important for the public. That is why we have spent a huge amount of resources improving the standards of hospitals in terms of facilities, beds and equipment.

Yesterday, the Tánaiste stated that resources will be targeted for improvements that will be made and she has outlined those. We have changed practices so that better patient care will be rewarded so we can try and deal with these matters. Diagnostic tests will be provided at weekends and evenings which will help the waiting time. New beds will be assigned immediately to accident and emergency units to ensure older people do not have the difficulties of being on trolleys. People will be discharged each day of the week to keep beds available, which does not happen at present in all hospitals. Discharges will be planned so that home care will be ready when patients are medically fit. We will put 3,000 new home care packages in place. People will be helped to move out of hospital beds by the provision of more home care packages and nursing home places. If patients go home they will get a home nursing home package to assist them which works very well in other countries.

The HSE will step up the pace of availability of home care places. It will fund as many places in the community and private sector as it takes. For the past umpteen budgets, the Government has put in additional resources to try to make this possible. We have bought and provided additional beds and built additional accident and emergency services. It is not a question of making excuses but we require the co-operation of those in the medical service. We are aware of the statistics; we do not need everyone telling us the figures every day because we are provided with them. We need people working collectively to try to resolve the problems.

In answer to Deputy Ó Caoláin, I wish the problems of dealing with industrial relations issues with the Irish medical service were as easy as he suggests because they are not and I have a feeling they never will be.

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