Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael) | Oireachtas source

It is very much a team here who are here to work with Members as a team. I thank the House for the acknowledgement that, when we all do well together, it is the people who benefit. That is the way we will work here. I say this on behalf of all of the Ministers of State here.

Deputy Rice made a very good point that this is not the most efficient way of using Dáil time. It is most unusual at this time until the legislation comes in and until the committees are structured. At least 37 people have spoken in this debate so allow me to try to respond as much as possible. I recognise that Deputy Rice has been here this whole time.

I thank Deputy Cullinane for highlighting some of the additional issues regarding the pressures on hospitals in January. Of course, where we have additional pressures, either from RSV or other pressures, appointments and surgeries are getting cancelled. The Deputy is right that this is precisely why the new elective hospitals have not happened yet and they must happen. This was linked to what Deputy John Connolly said about some of the procedures around that. I need planning permission to turn a hospital into hospital, so to speak, and the public infrastructure guidelines that go out to public consultation in these ways are not, strictly speaking, the most efficient way of doing that. I would like to try to do that slightly differently. I would ask for Members' help in that.

On Deputy Sherlock's points, I did attend with and met the rare diseases community today. Similarly, I met some from the Cared Ireland group, which was also highlighted by many different groups. I thank Deputies for raising the issue of HPV vaccination. I must highlight how important it is for boys as well as girls and the emphasis on that. The Minister of State, Deputy Murnane O'Connor, has answered on GP access but we can have a conversation about the Summerhill family practice because we do have some solutions to that.

I thank Deputy Rice for raising not just the digital structure but also the subject of digital health. The Deputy is absolutely right about the delay in delivering that and it needs to be done. As the Minister, I am glad my predecessors have done the work on the development of the app, which is at the first stage, but we need to continue to drive on that. Obviously I would like very much to be put under pressure to get the finance for that electronic health record, which is extremely important for everybody.

On Deputy Ó Muirí's point, I believe we have committed to that emergency department and to the additional block. My colleague, the Minister for Finance, Deputy Chambers, launched the Beaumont strategic plan a little while ago, so there is a strong commitment. I highlight to all Deputies that the HSE capital plan is coming and a very significant body of work in this regard is outlined there.

I thank Deputy Burke for raising the complex issues with emergency presentations. Of course consultants are not the only part of that, as Deputy Cullinane also recognised, and there are multiple different factors. One of the things I have highlighted is the bank holiday weekend precisely because that was one of my first weekends there, but this is an every weekend problem.

I would expect to see in the scheduling consultants routinely being there from 8 a.m. until 6 p.m. on a Saturday, not 8 a.m. until 2 p.m., thereby reducing the time when there are no senior decision-makers present. Of course, they have to be supported by the rest of the team in the hospitals and by diagnostics. That is very much an inconsistent experience at the moment. In some hospitals, there is access to diagnostics. In some, there is not. That is not okay. I need to be able to come to the Chamber and confidently say that there is a consistent experience across Ireland.

Deputy Ward recognised the experience in Letterkenny and Deputy Pa Daly recognised the experience in Kerry. It should not be a geographical accident. While I am highlighting these examples as regards the broad trends I am seeing, I recognise that there are local differences and nuances and that this is a broader, whole-of-region responsibility as well as a whole-of-hospital responsibility. I welcome the debate by Professor Collins and others in this space because it highlights some of the issues we need to focus on. At the end of the day, there is a weekly spike that is exacerbated on bank holidays because of the two-day window where there are not enough people, including consultants, working. I have tried to track resources and the scheduling of resources over the past number of weekends.

I thank Deputy O'Donoghue for highlighting Limerick and the substantial body of work to be done there. I compliment Limerick on its response to Mr. Bernard Gloster on the scheduling that it anticipates over the next number of weeks. The hospital's response was one of the best and most proactive. There is a balance to be achieved. I also compliment Limerick on the fact that it progresses its elective surgeries when certain hospitals cancel them.

I will do my best to try to flatten those lines to make the approach across Ireland more consistent and there are not geographical differences.

I thank Deputy Timmins for raising the issue of transparency in terms of pricing and pharmacies. It is a long-standing issue. When we had the energy credit scheme, it appeared on our bills - on my bill, at least - as a credit put towards the charge. Taxpayers understood that it was their taxes, not Government money, contributing towards paying their bills. It should not be a million miles away with pharmacies. If I get a bill, I would like to see what the cost of the medicine was, what the cost of the dispensing fee was and what the State paid towards that, recognising that the State is paying €500 million of taxpayers money to pharmacists every year to support taxpayers in accessing medicines. There is a lot of merit in what the Deputy is describing. Let us have a think about the best ways we might approach that. This issue has also been highlighted in respect of HRT.

I will take ten seconds to pay tribute to my predecessor, Stephen Donnelly, who put enormous work into this position, developed the database and placed a strong emphasis on data, process and productivity that has led to significant improvements.

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