Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

-----and saying that this works for patients and that it has to work right across our system. If we are going to achieve our common goal of universal healthcare for people in this country, we need record levels of investment in capacity, which is happening, and at the same time we must see a radical agenda of reform right across the system. We have to achieve both.

Several Deputies have asked what is left in terms of hospital charges for patients. There are only two things left. First is a €100 charge for the accident and emergency department if a person does not have a medical card; otherwise it is free for a medical card holder. Second, there is a €75 charge for an injury unit. We would like to see those charges brought down over time. These €100 and €75 bills are significant for people to pay and if they have children, like I do, they might find themselves in these injury units and accident and emergency departments and paying those bills more often than they would like to. We want to bring them down.

GP care will become more affordable, and later this year for the first time ever over half of the population will have State-funded access to general practice, which is a big moment for our country. As we make GP care more affordable, we can look at bringing down those two remaining hospital charges. We all know the reason they are there. If it was cheaper for people to go to an accident and emergency department or an injury unit than a GP, inevitably at the margin people would do that. We know our accident and emergency department staff are already working flat out and working too hard in many of our hospitals. We do not want that to happen but it is something we can look at in the future.

I also want to take a moment to thank colleagues for the support across the House for the new consultant contract. It is an important contract and an attractive one. Later this year, the base salary at the top of the scale will go to about €261,000 and with on-call allowances, the amounts of which have been increased as well, many consultants in our system will be earning in excess of €300,000 per year for a 37-hour week.

A lot of them do a lot more than that unpaid and I acknowledge that. It is nonetheless a very attractive contract for doctors. Our hope is that the doctors we are training here as non-consultant hospital doctors, NCHDs, will take these posts when they qualify as consultants and that a lot of consultants around the world - Irish-trained consultants who living all over the world - will begin to come home and take up this contract.

Critically, this contract also works for patients. It does two very important things. First, it doubles the regularly rostered hours in which we can provide services in hospitals for patients, from about 40 hours a week to about 80. That will be phased in over time as we build up the workforce further. It is a fundamental change in hospital access for patients. That is important. Second, it helps drive forward another common goal, which is removing private care from public hospitals. Deputy Connolly asked why people are asked for their insurance details when coming into a hospital. That is because the hospitals want to make money out of it. In some cases the clinicians and consultants want to make money out of it. In some cases patients can end up with better facilities and may have more access to a consultant rather than the NCHD in an operating theatre, for example. That is not always the case but there would be a perception among some of the consultants I talk to that that is one of the reasons. We want to end that. More and more hospitals are now not asking for insurance details and patients are pointing out they are a public patient in a public hospital and their insurance details are not relevant. We have a role to play in government and in the Oireachtas in agreeing that the money lost by public hospitals must be replaced by the Exchequer because we want public patients treated. We cannot disadvantage the public hospitals in terms of that funding.

I again thank colleagues for their support for this Bill, for the direction of travel towards universal healthcare and for the very strong support I have heard this evening for the new consultant contract.

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