Joe McHugh (Fine Gael)

Any attempt to address the anomalies in the supply of professionally trained doctors or the restrictions at entry level, including the Fottrell report, has to be welcomed. In my first year of teaching at secondary level, I encountered a student who excelled in her first year with A grades in every subject. Already ahead of her peers at that stage, she continued to perform well throughout second and third years and received top grades in the junior certificate. From first year, the student's goal was to study medicine, an ambition she fulfilled after getting maximum points in the leaving certificate. However, after studying medicine in Trinity for a year, she realised it was not the course she wanted to do.

My story is an example of the carrot and stick faced by many people. Is the expectation of points a sufficient reason to apply for dentistry, veterinary or general medicine? Are we using the correct motivational tools for people entering particular disciplines? Students often choose these subjects, or are pushed to do so by their parents, simply because know they will get the requisite points. That is not a good enough tool in terms of getting people into appropriate specialties.

It is important, not only at university level but also at secondary level, that a greater emphasis be placed on progression. Career guidance teachers have a restrictive mandate and there may only be two of them in a school of 500 pupils, which is insufficient to give one-on-one supervision to students' progression in terms of finding out where their talents lie, what they want to do and where they want to go. More tools should be available at secondary level to help students decide their futures.

The number of undergraduate places for medical students will increase by 250 over the next four years and by 40 in this year alone. Will there be associated costs for these courses and, if so, will those costs be prohibitive for some students? Senator Mansergh hit the nail on the head with regard to the financial insecurities experienced by people who wish, for example, to pursue six year courses in medicine or dentistry. In terms of the announcement of €200 million, where is the costing for this figure? The figure of €200 million has been thrown out for these extra courses. Is there any breakdown of the proposed expenditure or a timeframe for it? The Government is good at making announcements and I recognise the ability of Fianna Fáil and the PDs to come up with fantastic spin. The Transport 21 plan was not costed and had no timeframe and this €200 million is the same. We do not know how the figure was calculated or how it will be spent. This Government will have a legacy of spin. We are not managing the money generated by the hard working taxpayer properly.

The cap on Irish students was addressed in the Fottrell report. We put 750 students through medical training every year but there is a cap of 300 on the number of Irish students. We facilitate 450 students of non-EU origin. I am not arguing against that, we should facilitate it because it generates income for universities. We should, however, raise the cap for Irish students and facilitate secondary students by reducing the number of points necessary for entry. That would allow good Irish students who are capable of being good doctors to come through. Universities face problems in funding, they are at a disadvantage and they get extra revenue from non-EU students so it is important they continue to be able to take such students in but the cap on the numbers of Irish students should be raised.

We do not need another task force on rolling this out, another aspirational plan from consultants. There are templates to facilitate this process, such as the computer package at the University of Limerick. We should not waste extra resources on consultants, reviews and task forces.

The document contains the target of 2,500 extra consultants in the next ten years. It would be great to see it but is it achievable? I hope the figure has not just been plucked from the sky.

I welcome this report. Elements of it are vague but that can be addressed. My colleague in the Dáil will table a series of parliamentary questions in the next few weeks to elicit more information. It is important that we review the holistic aspect of why students want to enter medicine, how they go about it and the processes involved. At present, entry is not based on merit. There are constraints for families who cannot afford the substantial expense involved in going to medical school.

These are the challenges. We must look at the entire process, not just at the student who has just completed his or her leaving certificate, but at the child leaving national school. We should look at the help offered to students who want to be doctors. Students who do not get grade A results in first and second year in the junior certificate have already decided they are not capable of being a doctor. It should not be a race because it will turn into a race to the bottom if we do not look for the most capable people.