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

I saw the programme last night and it was a very interesting piece of high quality investigative journalism, examining statistics and following individual consultants in the course of their work. I would like to say I was surprised by the outcome but there has been anecdotal evidence for a long time in the health service of a minority - perhaps not a majority - of consultants not fulfilling their contractual obligations. They are not doing the public hours they are paid for and are seeing more private patients. The practice is deeply offensive and it must change.

I remember when I was Minister for Health I asked for an audit to be carried out of accident and emergency department consultants to see how many patients they saw. This arose because of a tip-off from other department staff who were concerned that consultants were not seeing very many patients who came in the door. They were seeing patients in review clinics and private clinics relating to legal reports. They did not see the people coming in the door from ambulances in big numbers. To my knowledge, that was never done. In many ways, what we saw last night speaks to something I have raised on many occasions.

That is something this Government now has to deal with.

On the issue of waiting lists, the Deputy may not be aware that the waiting list for procedures for inpatients and day cases has now fallen for three months in a row. Part of that is down to the additional resources we are putting into our public hospitals. Much of it is down to additional funding for the National Treatment Purchase Fund, NTPF, and I believe we will see waiting times falling for cataract and procedures such as hips and knees falling in the year ahead. Between April and now, the overall number of people waiting for an ophthalmology procedure fell from 13,552 to 11,863, and the cataract waiting list has fallen from over 10,000 to 8,667. We are starting to see results in terms of the additional money being given to the NTPF, and also the additional funding provided for insourcing, to do more work in our public hospitals.

On the fundamental issue, the Sláintecare report and the all-party report on the reform of health, one of the recommendations was that we take private practice out of public hospitals. I agree with that; it is a good idea. The report recommends that a commission be established to examine how that would be brought about. It would be costly at approximately €700 million in a year and would involve changes to contracts. The Minister for Health, Deputy Harris, has already appointed that group, which is headed by Donal de Buitléir, to examine exactly how we can do that. It would be - if and when it happens - a game changer for our public health system. We would never allow what happens in our public hospitals to happen in our schools. Children could not come in to be taught in a private class with fewer pupils and a teacher who is paid more to teach them. We would never allow that, yet we allow it in our health service. I do not think we should. It means there are perverse incentives for hospitals to have more private patients because they can then generate additional revenues. Our public hospitals get about €700 million in additional revenues. In addition to that there is a perverse incentive for the individual consultant to make more money in that way. It has to change.

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