Mary Harney (Dublin Mid West, Progressive Democrats)

It is good to listen occasionally. In regard to co-location, the only ideologue that opposed it was the former Deputy Joe Higgins. There was not a single other opponent. He has appealed the matter to An Bord Pleanála. We know what the former Deputy Higgins's ideology is. As Deputy Reilly knows well as a medic, half of the patients being seen in some of our Dublin hospitals for elective procedures are private patients going into public beds on a preferential basis. That is why there will be a new contract of employment for consultants which is a fundamental overhaul of the current situation where they effectively work as lone rangers in hospitals but not for hospitals. Under the new contract they will work as part of teams with a clinical director and the team will be responsible for providing cover.

In regard to some of the other moneys we are taking from the health and children Vote — reference was made to the fact that one third of the money comes from health and children, and that is the case — all the new developments are starting. There are timing issues. Professor Keane got €15 million to recruit new consultants and for other developments in the cancer control area. He is recruiting new consultants, but he does not need €15 million this year, he needs €12 million. That is proceeding. The same applies to the pneumoccoccal immunisation vaccine for a form of meningitis. Every one of the developments, including palliative care, is proceeding. None is cut back as a result of the decisions made.

On the broader reforms within the HSE, like every other organisation the HSE must operate within the budget allocated to it by the Oireachtas. The budget is not inconsiderable at more than €15 billion. The HSE must make sure it commits to the service development on which I signed off at the start of this year in relation to 2008. It has assured me it will do that. Clearly it must organise services in the most cost effective way, bearing in mind its first obligation is to patients. Earlier this week there was a controversy at Louth hospital which I will mention in passing. We paid two doctors overtime for out-of-hours services and there were 14 patients who attended out of hours. When the patients arrive the senior registrar who is also on call must attend. From here on when the patients attend the senior registrar who is on call will deal with them. I give that as an example because we spend €135 million on overtime for junior doctors. Last year 20 of them got more than €100,000 in overtime. Those kinds of decisions are sensible.

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