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

We all need to consider this one carefully because we have to ask ourselves what consultant cover actually means. We have very large emergency departments in this country with four and five emergency department consultants who are not in the departments after 6 o'clock or 8 o'clock at night. They are on-call from home or, in some cases, they will not cover weekends. Even with four or five consultants, either because of unwillingness or too onerous a rota, we do not have 24-7 consultant cover. I am not sure we have that in any emergency department in Ireland; they are probably on-call from home.

We have only a limited number of specialists, and we have to consider the level of patient safety risks we are willing to accept. If it is not possible to recruit people to cover a special service 24-7, or if there are not enough patients for them to keep up their skills in which case they cease to become specialists, we have to decide if we are unwilling to accept an inferior and non-specialist service just because it is local, and that is not particular to Portlaoise as it also applies elsewhere. One of the big struggles that will happen in Portlaoise is hiring the additional consultants for obstetrics and paediatrics. We need those additional consultants in obstetrics and paediatrics to ensure there is senior cover in that unit, but what if we cannot recruit them? We have serious difficulties recruiting people. The Rotunda hospital advertised two jobs not that long ago and did not get any applicants. We need to have a very serious conversation with the public as to what we do if it is not possible to staff units with specialists. Are we willing to accept an inferior service on that basis?

See this speech in context