David Cullinane (Waterford, Sinn Fein)

No, there was an internal one that the story this broke in the media. I assume it is the same for the Minister, which is unacceptable. I know further investigations into this matter are taking place.

I am making the point that we have a system in this State where someone goes to a GP, is referred to a consultant and is then on that consultant’s list. There are bespoke options in some hospitals and some now operate what is called a centralised referral system. However, it was not the case in every situation and it does not currently seem to be the case in every situation. As I said, there is the potential for a perverse incentive for a consultant to manipulate public waiting lists and delay people getting access to care. In this case, the allegation is that it was with children - which makes it all the worse, in my view - in order to delay care and not allow other surgeons and healthcare practitioners to treat those children, but simply to treat them on a Saturday or Sunday and make money out of it. I do not know how widespread that is but wherever it happens, it has to be rooted out.

My understanding is that the CEO of the National Treatment Purchase Fund is not responsible to any Oireachtas committee and is not an Accounting Officer. That is a mistake. There are many issues. A huge amount of public money is being spent by the National Treatment Purchase Fund and it has particular responsibilities in regard to setting nursing home fees. I accept it needs to be independent in coming to those conclusions and not being affected by political influence. However, when it comes to the huge amount of money that is spent, as a former member of the Committee of Public Accounts, the Minister will know how important it is to achieve transparency. There are major issues that need to be examined. I have spoken to the current head of the HSE and I said that, for me, there are issues in relation to perverse incentives, the productivity of consultants across the system and conflicts of interest. Again, while I know this is an allegation and a contention, if it is the case that, as reported, this person delayed care for children, then made an application through the hospital for funding from the National Treatment Purchase Fund to treat the same children and did not disclose he was going to be the surgeon carrying out those private procedures at €200 a pop, that is a major conflict of interest that was not managed. I am deeply concerned about that.

I have dealt with hundreds of parents in recent months. Earlier I checked and saw that in the couple of hours before I came to the House, I had received 14 emails from parents.

I simply could not do justice to all of them in relation to the accounts they gave to me of their experience but suffice to say that all of them feel hurt and let down. They felt they were not listened to. They felt they were still being failed. They will have to wait now. We do not know how long it will be before this expert panel is established but they feel very angry. I want to be part of helping to restore their trust but unless there is a voice for parents and a voice for advocate groups in whatever arrangements are now put in place, that trust will not be repaired. That is hugely problematic. We all, in particular those in government, have a lot to do to repair the damage and repair the trust, which, undoubtedly, needs to happen if parents are to have trust in CHI again.

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