Willie O'Dea (Limerick East, Fianna Fail)

I propose to takes Questions Nos. 75, 86 and 87 together.

The PA report is an important milestone in addressing the challenges to the provision of medical services in the Defence Forces. Implementation will take time and commitment. On receipt of the report in June 2009, I accepted the recommendations and asked that implementation of the recommendations proceed immediately.

The report reviewed the medical services required for the Defence Forces in light of their roles and operations, assessed the current arrangements for the provision of medical services and proposed a model for future delivery of medical services. Some of the major recommendations are focused on making better use of existing clinical resources and thereby providing a better medical service and reducing the spend on outsourcing. The savings in outsourcing are to be achieved mainly through the re-focussing of medical staff on appropriate clinical tasks with administration functions being undertaken by non-clinical personnel; a reduction in the number of doctor interventions and medical assessments; and better management of health services outsourcing.

In order to achieve the saving in outsourcing, a major restructuring of the medical corps has to be completed. A number of working groups have been established to deal with the various aspects of this restructuring and several have already made recommendations which are being considered by the steering committee overseeing the project. As regards the frequency of medical assessments, one of the working groups is currently looking at clinical issues and has made recommendations which are currently under consideration. I expect substantial progress to be made over the coming 12 months in implementing recommendations. Some issues will be resolved quickly while others will require significant consideration and will, for example, require negotiation with the representative associations.

It is difficult at this stage of implementation to estimate the savings that can be achieved through reduced outsourcing as much of our requirement depends on a number of factors. However, I expect that savings on outsourcing could be made through the implementation of the PA recommendations. Implementation of the recommendations will result in major change at both strategic and operational levels in the Defence Forces. Thankfully in these difficult times, the report shows that major additional investment is not needed to meet the medical needs of the Defence Forces. Change will be achieved mainly through better use of the available resources.

Defence Forces personnel requiring medical treatment are getting the care they need. The services of civilian medical practitioners are used to provide backup to the medical corps in ensuring that the primary health care requirements arising in barracks are met. As the Defence Forces will never be able to meet all medical requirements from internal medical personnel, outsourcing will continue to be required. However, implementation of the PA recommendations will ensure that outsourcing will be reduced for primary care and that outsourced services will be procured and managed in a more cost-effective way.

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