Micheál Martin (Cork South-Central, Fianna Fail)

There is not a huge shortage. Thousands of people have been recruited. Let us be straight about it. The seven-day use of hospitals is something that should happen. It should not be dependent on more and more staff. The assets were not being used. Expensive diagnostic equipment was not being used optimally and the hospitals themselves were not being used optimally when there were five-day, nine-to-five services. Productivity matters, as do new devices and new technology. We need a broader approach to get better value for money. We have invested hugely in health and that needs to be acknowledged. Productivity and value for money are also factors. We are recruiting a further 6,000 in 2025, in addition to the 30,000 that have been recruited. I accept the population is increasing and that will create demand for services. It has created a lot of demand for health services. The population is ageing, which is creating further demand for the health service. That deal is a good one and will lead to greater productivity in hospitals and health services.

On mental health issues, the Minister of State, Deputy Butler, has been doing significant work on eating disorders. Deputy Devine could talk to her about the specifics of the cases she has raised. We need more investment in eating disorder centres but we have had some. A lot of progress has been made in that respect.

Deputy McGuinness raised cardiac care. Much progress has been made in the past five years in respect of cath lab investment in Waterford. It has been incrementally building up. There has been quite good investment in the past two to three years. Now we will complete that in terms of 24-7 provision. That is a Government decision that has been taken and that will happen. Recruitment in healthcare takes time. It does not happen within two months but it will happen and that will be developed, as committed to by Government.

Deputy O'Sullivan raised the reimbursement of medication. More progress needs to be made on the reimbursement of medicines. Quite a lot has been made. I met IPHA representatives who represent the pharmaceutical industry here. Understandably, it is promoting this but when I questioned IPHA members two years ago, they were more or less saying they had a good enough relationship with the national pharmacovigilance unit. As a country with a strong concentration of pharmaceutical companies and which produces some of the most effective medicines in the world, we should have a modern, up-to-date reimbursement process. However, that has implications for public expenditure. Progress has been made but we need to make more, and we need to meet the standards and European norms.

Deputy Cahill raised the shingles vaccine. I do not doubt the benefits but the expenditure would be significant. We need to bear that in mind.

I join Deputy Ó Murchú in offering sympathy to Kofi's family. It is heartbreaking that any young person so talented and with so much to offer in life should die in such circumstances. The Deputy mentioned Isobel McCluskey as well. The national emergency forum - there is a more precise title for it - did a lot of work on water safety in terms of swimming in rivers and in the sea over the past two years, and on prevention. One of the most effective interventions in healthcare is prevention. Public health messaging on accidents is a key dimension of that and is a factor in injuries and deaths. Our sympathies go to all in the community and the families affected.

Deputy Murphy raised the issue of allergies. We have multidisciplinary teams involved in allergy.

I defer to medical and professional advice within our own system on the provision of oral immunology therapy. It is a complex area that takes a lot of building up of immunology. A lot of children have spent a lot of time with consultants so I am slightly worried. I am not an expert on this but I defer to proper, professional advice as to when such medicines could be accessed or used. I say to everybody out there to consult their GP and consultant in respect of the utilisation of any therapies in that regard.

Deputy Connolly mentioned nursing and 6,000 critical skills permits, of which I think he said 5,000 were in nursing. There are two ways of looking at it. A lot of young graduates travel and have been travelling for a long time in the medical world. There may be an issue of retention. Some come back to work in Ireland later on and there are huge specialties available to nurses in Ireland. There are huge programmes, including postgraduate programmes and specialist programmes. We have developed the likes of intensive care nursing and cardiac nursing very well with native talent. There has been phenomenal change in nursing in Ireland over the last 20 years, from the degree programmes to the postgraduate programmes. However, there is an issue of retention and retraining people and we have to be more innovative in terms of how we do that into the future and we then attract nurses from other jurisdictions into the country.

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