Bertie Ahern (Dublin Central, Fianna Fail)

I understand the agenda of the Deputy, who has visited all the hospitals in question. We are tracking each other in that I have been to most of them also. I have heard the negative comments but have also heard an endless number of positive ones. People who have been in for major cardiac surgery, heart and lung transplants, maternity care or other kinds of treatments, including people who believed they were on death's door, have said they were treated well. It is true that I have encountered problems and seen old buildings that in my non-professional view are past their sell-by dates and can never be addressed and that is why we are investing the resources.

There are 140,000 positions, including 100,000 full-time equivalents. There has been a great increase in the number of doctors, and the number of consultants has doubled. There are thousands of extra nurses and an additional €11 billion or €12 billion has been spent in a short period. Spending compares well pro rata against that of other countries and problems are being addressed.

I agree with Deputy Kenny that there are problem areas; there is no doubt about this. If the consultant in Tralee could use his influence to complete the consultants' contract, it would help to deal with some of the endoscopies. If he could put a word in with his union, in addition to talking to the Deputy and me, it would also help. The Deputy is correct that certain reforms are required. We are trying to make these reforms in the ongoing negotiations.

If, in any area of life, one goes around the country looking for problem cases, one may find them, but one must acknowledge that, according to independent surveys, the vast majority of the 1 million patients in our public hospitals last year were happy with the service. There are problems in accident and emergency wards, that is why we are building so many new units, why we are putting so many extra services into accident and emergency wards, why we are setting up primary care teams and injury clinics, why we have emergency consultants working in accident and emergency and why we have increased the staff in accident and emergency.

Many of the buildings are just not suitable for the necessary developments but there are construction programmes in every area. In Drogheda, there is an ambitious plan for the whole north east. The Teamwork Management Services report spelled out what is needed in that area. I admit the report points out that the present system, whereby five local hospitals in the north east deliver acute care and services for people with severe illnesses to a relatively small population, has exposed patients to increased risks and this must change.

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