Camillus Glynn (Fianna Fail)

Tá fáilte roimh an Aire go dtí an Teach. I welcome the Minister to the House and the opportunity to speak about the Hanly report, the third of recent times, preceded as it was by the Prospectus and Brennan reports. The Hanly report sets out a series of principles for the future organisation of hospital services nationally alongside measures to reduce junior doctor hours, improve training and introduce a consultant-provided service. It recommends investment in local hospitals to provide more services for patients, including elective medical and surgical procedures, out-patient services, prenatal and postnatal maternity services and better access to diagnostic facilities. It states that the full range of acute hospital services should be available within each region so that patients do not have to travel beyond it other than for services best provided at supraregional or national level.

It is important to point out at this juncture that, while we would all like to have a centre of excellence in our back yard or home town, that is not a runner in reality and we all know it. Experience has taught us that in the case of breast cancer. It has been proven scientifically that unless 100 procedures are carried out at a centre in a given year, it is not safe to practise them. Those who have been stating that very loudly are those who would benefit from the change, namely, Irish women. The report proposes developing the minor injury and illness services in local hospitals that currently account for 70% of patients attending accident and emergency departments.

The Hanly report concludes that the only way to address reductions in the working hours of junior doctors while providing high quality patient care is to introduce a consultant-provided service. The Government is committed to putting in place a consultant-provided service harnessing the contribution of all our hospitals and providing a wider range of appropriate services and procedures in local hospitals. Every facility involved in health delivery has a very important role to play and that should not be minimised. However, that will be done if people wish to serve a political agenda. The background to the National Task Force on Medical Staffing was that the European Working Time Directive requires us to reduce the average working hours of non-consultant house doctors from the current 75 hours per week to 58 hours by 1 August 2004 and, ultimately, to 48 hours per week by 1 August 2009.

Most, if not all, Members have, from time to time, been involved with trade unions. There are not too many people in employment who are obliged to work the same number of hours as non-consultant hospital doctors. There is light at the end of the tunnel for GPs because, thanks to the efforts of the Minister, Deputy Martin, my area recently received funding for the out-of-hours GP service for Longford, Westmeath, Laois and most of Offaly. People must recognise that doctors are human and that they cannot work for hours on end. As someone who worked in a particular discipline for many years, I am in a position to say with authority that the working conditions and hours of NCHDs are nothing short of scandalous. I do not know why anybody would want to enter the medical profession and work the hours junior doctors are obliged to work.