Mick Wallace (Wexford, Independent)

I would not claim to know much about medicine or how the health system works, but I am very interested in it. Given that I have so much to learn about it, I would have liked to have got the Bill earlier than yesterday. The HSE seems to be a monster that is out of control, much like the NRA in the transport area. Too much decision making has left this Parliament and gone into the hands of civil servants who could be good, mediocre or disappointing. These are people who cost a considerable amount of money. In the long term we should not relinquish so much power to bodies such as the HSE, the NRA and many other quangos which have more power then they are entitled to.

It is very disappointing that we are educating Irish students who are not here to fill the vacant posts. Deputy Clare Daly stated we should consider making it a precondition that there be some payback from those students and that they be required to serve here for a period of time before disappearing to greener grass. I do not blame anybody for wanting to travel, which is good, but if the taxpayer goes to such expense to train these people it is a pity if the State does not get anything in return.

I do not agree with Deputy Ó Cuív who said we were robbing the Third World by bringing in Indian and Pakistani doctors. In the construction sector I had approximately 80 people from eastern Europe working with me at one stage. If I did not have them we would not have got the work done at all. They were very good workers who were honest in their approach. We paid them the same wages that we paid Irish people and it was good for both sides. I do not see a problem with employing people from other states; we need to be more open than that. We must remember that the Irish doctors who are not filling these posts are going abroad and being accommodated and welcomed in other countries. What is sauce for the goose is sauce for the gander. I have found all Pakistani and Indian doctors I have met in my life exceptionally good. An Indian doctor has been working without pay for the past five years for Wexford Youths. He is an absolute gentleman and brilliant at his job.

Deputy Twomey made some good points - he knows more about the set up than I do. He mentioned the problem of the number of faceless bureaucrats in the HSE which needs to be addressed. He also said that accountability and transparency are lacking. This is not particular to the health service and goes through many aspects of Irish life. We just do not do accountability and transparency very well. It would be wonderful if we changed our approach. The lack of accountability and transparency is soul destroying for people observing what is going on all the time.

I will not waffle on about a topic about which I do not know much. During this week's debate on the Private Members' motion, Deputy Ó Caoláin said:

It has been known and widely recognised for years that the hospital system is totally over-reliant on junior doctors. Successive Governments have failed to address [this] and now it is looming again, worse than ever. Recruiting sufficient additional junior doctors will be required in the short term, but this is not enough. Nurses [need to] be freed up to fulfil more responsibilities in [our hospital A&E] departments as they are qualified and willing to do this work. Hospital consultants [must] be required to fulfil their contracts to serve the public hospital system, contracts which [are being] widely breached. More consultants are required in [our] public hospital system [and] the current excessive remuneration for consultants [needs to] be reduced to facilitate the employment of more consultants.

The House does not need to hear from me that consultants in most areas of governance in this country are madly overpaid. I have heard they do not totally fulfil their obligations to do work on the public side because they are too busy making a fortune on the private side. This must be addressed because it is a serious abuse of the people.

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