Mary Harney (Dublin Mid West, Progressive Democrats)

I do not accept that I have no mandate. The Government made a policy decision in 2005 and it is a matter for the HSE to implement it. We do not put the implementation of policy on hold in advance of or during elections.

Everybody is entitled to access the public hospital system. Universal coverage is available in Ireland, which is not the case in other places. At present, however, not everybody accesses the system on the same basis. Those with private health insurance — I understand Deputy McManus published data in that regard — have easier access to the public hospital system, which is not good. I believe everybody should be equal and that is why I disagree with, for example, charges for accident and emergency services. When it comes to the public hospital system, which we are all entitled to use, we should allow access based on medical need and not because some of us have insurance and therefore can get into beds that are ring-fenced for private patients. Recently, I wrote to the HSE to recommend the prioritisation of these beds, many of which are in small or single rooms, for infection control purposes where necessary.

With regard to the charge to the hospitals, I said in my reply to Deputy Twomey that the eight hospitals concerned received €96 million last year for the beds being moved from public to private hospitals. That figure will be the revenue cost to the hospitals, excluding the moneys raised from leasing the land, which exceeds the commercial valuation because of the advantages offered by collocation.

The current contract of employment for consultants, which cannot be broken other than by agreement, gives consultants the right to 20% private practice on public hospital sites. In all eight hospitals, the intention is that the consultations will carry out work on the site and not in the public hospital, in line with their contract. We are seeking to negotiate a new contract with the consultants and the Government extended the period for negotiations by a further three weeks to 17 April because of the optimism expressed by the chairman of the talks. We want to see public-only contracts for public hospitals, which I understand has been well received, and a range of other contracts. Certain existing contracts will have to be red-circled because they cannot be broken except by agreement. I hope we can have a new contract of employment which attracts many of the existing consultants to work in teams under clinical directors and to provide greater flexibility, longer days and different rosters, all of which have been very successful in other hospitals around the world.

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