Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I am no expert in this area and have not been particularly involved with it in any personal way but there are a few points that I would make. I think it is inappropriate for any section or department within a hospital to declare itself a national centre. If there are national centres, they should be designated either by the HSE or the Department of Health, or by some other body. It is inappropriate in general that any department or subsection of any body should declare itself to be a national centre. I hope Deputy Kelleher would agree with me on that.

Regarding the rare diseases plan, it is not specifically mentioned in the 2015 service plan but it is mentioned in one of the operational plans which flows from the service plan. I will be very keen to see the office established this year if that is possible. Of course, that is ultimately a decision for the director general of the HSE.

When it comes to all matters, frankly, I think GP referral is appropriate. If people self-refer to specialists we will have huge numbers of people referring themselves inappropriately, thereby creating waiting lists to see people who do not need to be seen. The whole point of going to a GP first is that the GP operates as a gatekeeper and ensures that only appropriate people are referred to specialist centres. That is the way it works across the public health service and it is a good system in my view.

Clearly, there is a dispute here between some of the staff in Crumlin on the one hand and the CEO and the board of Crumlin on the other. I do not think disputes within a workplace or institution should be resolved in Parliament. That is not our role. It is important that, if there is a dispute in a workplace or hospital, it is resolved using the appropriate mechanisms within that hospital.

See this speech in context