James Reilly (Dublin North, Fine Gael) | Oireachtas source

A reduction in staff does not necessarily mean less service. We are seeking to reduce the cost rather than level of service provided. This policy forms part of the Government's general approach to public services. We must reduce our cost base because we became uncompetitive. We are, however, becoming more competitive and we must secure further reductions across the board. Everybody understands that we cannot continue to spend more than we raise in taxes.

There is room for major improvement in certain areas of the health service. I refer specifically to community nursing home units where we are struggling in many cases to achieve a nurse to health care assistant ratio of 1:1. The Royal College of Nursing in England has indicated the ratio should be 2.5 health care assistants per nurse. Moreover, consultants are seeing patients who could be treated by general practitioners and GPs are seeing patients who could be cared for by nurses.

Nurses are looking after patients whom health care assistants could be looking after. A prime example is provided by a study conducted at St. Mary's Orthopaedic Hospital in the Deputy's county of Cork.

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