Mary Harney (Dublin Mid West, Progressive Democrats)

I am talking about the average stay in Irish hospitals in 2005. Central to appropriate discharge policy is having a consultant in the hospital whenever one is required, and certainly to have 24-7 cover for the main specialties. The reality is that if this does not happen, daily ward rounds and daily discharges cannot happen. We all know that doctors who are not at consultant level tend to admit people more frequently and do not tend to make decisions on discharges except when the consultant is away on holidays or otherwise.

Above all else, with this new consultant contract we want to ensure consultants work on a 24-7 basis and as part of a team, not as single operators. We want to ensure a clinical director is in charge of that team because everybody will acknowledge that having administration and management interface with clinicians does not deliver positive outcomes as far as best practice is concerned. That is how the best hospitals in the world are organised — indeed, Ireland has some small examples of hospitals organised on the clinical directorate model. That is the essence of the contract of employment the Government wants for new consultants, hopefully with as many of the current consultants as possible working in our health care system.

With regard to the public private mix, the Deputies opposite talk about co-location as if we had no private activity in our public hospitals. Governments for many years, certainly since the 1970s, have ensured that when a hospital is built, 20% of the beds are private beds. In our major hospitals, the situation is as outlined by Deputy McManus, namely, there is a private wing or private wards and the beds in those wards are only available to private patients, insured patients. No matter what public patient case arrives, no matter how urgent, the patient cannot access those beds, and that is wrong.

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