Jimmy Deenihan (Kerry North, Fine Gael)
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Question 103: To ask the Minister for Defence if he has satisfied himself with the resources being provided to the medical corps within the Defence Forces in view of the fact that a large number of the sick days being taken by soldiers are due to delays in waiting to attend consultancy appointments and delays in being assessed by medical boards; and if he will make a statement on the matter. [3727/09]

Willie O'Dea (Limerick East, Fianna Fail)
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Military medical services and their facilities exist to maintain the health of the Defence Forces and to support them in operational and overseas activities. The focus of the military medical service is on primary care, occupational medicine, acute trauma management, preventative medical programmes and field medical training.

A key issue in the provision of medical services to the Defence Forces has been the shortage of medical officers, namely doctors, in the medical corps. The services of civilian medical practitioners are used to provide back up to the medical corps in ensuring the primary health care requirements are met. The difficulties with the recruitment of medical officers have endured for some time, despite the concerted efforts of my Department and the Defence Forces. The numbers attracted to work in the Defence Forces have served only to address natural wastage. The pay and allowances of doctors and dentists were increased substantially in consultation with the Minister for Finance. In addition, the Defence Forces have undertaken an intensive recruitment campaign. The results of both of these initiatives have been disappointing. Apart from the issue of the numbers of medical officers, a review of the provision of medical services, in association with the representative associations, is ongoing as part of the modernisation agenda for the Defence Forces.

In view of the complexity of the challenge facing the Defence Forces in this area, I decided to engage consultants to make recommendations on the best means of meeting the medical requirements of the Defence Forces. The consultancy is focusing on the sustainable provision of the relevant medical expertise and services to the Defence Forces. PA Consulting was awarded the contract for the medical consultancy. I eagerly await receipt of the report and assure the House that following consideration of the recommendations, I will publish the report and engage with all of the key stakeholders with regard to its implementation.

I understand that in referring to consultancy appointments, the Deputy is referring to appointments with medical officers of the Defence Forces medical corps. Improvements in the provision of medical services will contribute to ensuring that absences due to sickness in the Defence Forces are kept to a minimum. My Department is addressing the issue of sick leave arrangements more broadly in tandem with the consultancy. A review group representative of my Department, the Defence Forces and the representative associations has been established to ensure that military sick leave arrangements are the most appropriate and in line with current best practice. Notwithstanding the current situation, I assure the House that Defence Forces personnel requiring medical treatment are getting the care they need.

Jimmy Deenihan (Kerry North, Fine Gael)
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Will the Minister clarify, if the medical service is adequate and he is satisfied with it, why 135,000 sick days were taken last year by just 20% of Defence Forces personnel? Does the Minister agree this is, in most cases, because of the absence of a proper and well-resourced medical corps for the Defence Forces? A soldier on sick leave may have to wait for weeks, or months in some cases, before he or she can access the medical board to certify fitness to return to service. I point out to the Minister that, as reported recently in the newspapers, these sick days are confined to approximately 20% of the Defence Forces.

This is a major issue. I am aware the Minister has appointed consultants whose report we have been awaiting for approximately a year. It is amazing they are taking so long to come up with recommendations. This looks bad for the Army and the Defence Forces. It is unfair that those people who want to return to work cannot, in many cases, get treatment or clearance from the medical board. The Minister may not be aware that a member of the medical board cannot have seen or treated any of these people previously or he or she is ruled out of being on the board.

Is the Minister aware or concerned about this problem? Apart from waiting for the consultants' report, what is he going to do about it?

Willie O'Dea (Limerick East, Fianna Fail)
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Deputy Deenihan asked if I was satisfied the current service is adequate. A number of issues are involved. First, it is adequate. Any soldier who needs primary care will get it. I agree there is a shortage of doctors in the Army, but we have an arrangement, as the Deputy will be aware, with civilian doctors who step into the breach. That has been the established position for many years. I reiterate that any soldier who needs immediate medical treatment will receive it within the same timescale available to any other person in the country.

I agree there were 135,000 sick days last year. This works out at approximately 12.99 sick days per individual. My advice is that while this is a large number it is not wildly out of line with the rest of the public sector. This gives me some satisfaction because the nature of military duties means that a minor injury which might not prevent somebody from working in an office might prevent him or her from undertaking military duties in view of the consequent risk. While a total of 12.99 sick days per person is not grossly out of line with the rest of the public sector, nevertheless there is room for improvement and I take this point.

Brendan Howlin (Wexford, Labour)
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I want to allow a brief supplementary question.

Willie O'Dea (Limerick East, Fianna Fail)
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Deputy Deenihan asked me a question about the medical board and I will answer it.

Jimmy Deenihan (Kerry North, Fine Gael)
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The figure for sick days is out of line. With regard to sick days, the figures I have show that the average in the public sector is 3.5 whereas in the Army it is 13. The nature of being involved in a military force is different from being involved in the Garda Síochána or other occupations. The training is very physical, much time is spent outdoors and the people face challenging situations. This is why they need adequate medical backup. There is a fundamental failure in our service to our Defence Forces which is reflected in the number of days spent on sick leave. People who do not want to be on sick leave cannot get treated or be seen by consultants or the medical board. It is serious and the Minister must deal with the matter as soon as possible and not wait for a consultancy report which may not come out for another year given the way consultancy reports are finalised.

Willie O'Dea (Limerick East, Fianna Fail)
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According to the official script I received from the Department, sick leave in the Defence Forces is not significantly out of line with the range across the public service and this is the information on which I am relying.

Jimmy Deenihan (Kerry North, Fine Gael)
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It is wrong.

Willie O'Dea (Limerick East, Fianna Fail)
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I do not accept for one second the contention that there is extra sick leave in the Defence Forces because people cannot see a doctor quickly. People in the Defence Forces can get treatment for primary medical conditions and see a doctor as quickly as anybody else. Even though we do not have sufficient doctors in the Army there is a very good arrangement between the Army and civilian doctors who provide their services.

Jimmy Deenihan (Kerry North, Fine Gael)
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What about the consultants and the medical board?

Willie O'Dea (Limerick East, Fianna Fail)
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So far as the consultants' report is concerned, I concede that I expected it by the end of last year. It has not arrived. I asked about it again today and I expect to have it within the coming weeks. I understand it was ready but was held back to make improvements which is fair enough.

With regard to medical boards, I accept the point that there are delays due to the small number of doctors we have and the fact that they are geographically spread. As Deputy Deenihan rightly stated, neither of the two members of the medical board can have seen the person previously.

Jimmy Deenihan (Kerry North, Fine Gael)
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Can this be reduced to one and can ex-Army doctors be used?

Willie O'Dea (Limerick East, Fianna Fail)
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We are examining urgently a way to speed this up. The minimum period is 56 days but it is running well beyond this in some cases.