James Reilly (Dublin North, Fine Gael)

I will start with the Deputy's last point, lest I forget it. I do not agree that more beds closed means more patients on trolleys and more people waiting. I do agree with something I said myself when in opposition: "Not another bob more into health until the black hole is found and fixed."

We are in the process of doing that and of changing how hospitals operate and how and where operations are carried out. We are placing more emphasis on day surgery. People are being admitted into hospital the night before procedures when they do not need to be. They could be admitted on the day. Five beds have been freed up in the Mid-Western Regional Hospital, Dooradoyle, as a consequence of this happening.

Deputy Ó Caoláin asked if I agreed with the INMO trolley-watch figures and I said I did. I did not say I agreed with the bed closure figures. No joint study on bed closures between the INMO and my Department has taken place. While I do not utterly reject the INMO numbers I cannot accept them because I have not had advice from my own Department.

There are great inefficiencies in our system and much work is being done inappropriately. The basic principle of what we are trying to achieve is that the patient will be treated at the lowest level of complexity that is safe, timely and efficient and as near to home as possible. That remains the principle. We do not want patients going to see GPs when nurses could see them or going to see consultants when GPs could see them. We do not want operations being carried out in large hospitals, which should be reserved for more serious complex cases, when those procedures could be carried out safely nearer to the patient's home in smaller hospitals around the country.

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