Joe O'Toole (Independent)

Whatever the problems are, they certainly have not been resolved. Simply politicising them does not help our case. It has been noticeable and attractive during the past year to find the HSE picking up the ball on health issues rather than the politician as it always was before. This allows people to grasp and grapple with the issues.

We could and should do certain things which we have not done. The consultants' contract has not been dealt with. My view is that the Tánaiste has not offered enough money. I stated before that I would offer them more than €300,000 to be available, to work the appropriate number of shifts and to make progress. I would tell the consultants we would protect their contract for as long as they wanted to keep it. I am certain we can afford to pay that amount of money to consultants. Even though it would be less than what they may earn in the private sector, by the time the cost of running an office is removed and the importance of a pension is added, it becomes an extremely attractive proposal.

One of the main problems regarding consultants is that we do not have enough of them. Consultants have a say in who is appointed. They seem to take the view that anyone under the age of 43 or 44 is not old enough to become a consultant on the basis that they suffered for that length of time and so will the next generation. That is my view and I do not speak on behalf of anybody. From the outside, that is where I see the problem.

I would resolve those issues by taking decisions and progressing in a way that protects the consultants. We must recognise they are under an agreed contract. The only way to deal with it in HR terms is to recognise, acknowledge and respect that contract and allow the consultants to have it for as long as they wish. We must negotiate a new contract for new people. Decisions must be made on that basis.

The same must be done for other people. Senator Henry asked what discussion has taken place with the unions and the organisation representing all of the other groups working in those services. My understanding, and I may be wrong because it is based on anecdote rather than on official information, is that no real negotiations or discussions have taken place on how to do this. Until we can operate a system where all of our assets are operational and available for at least two shifts a day we will never deal with the issue. That must be done.

We must invest more funding in health. Members of the Government always begin their speeches by outlining the amount invested since 1997. Nothing is gained by that. If somebody stated in 1997 that a deal would be done to treble the health budget and double the number of people working in the health services, everybody would have thought it would solve the problem but it has not solved it and will not solve it. The Tánaiste is correct when she states it is not only about money. At the same time, she should qualify that by stating more funding is required. We must set about getting value for money and the service required.

On a number of occasions, the Tánaiste raised the issue of GP clinics. That is an important part of the issue. I have no doubt that people do not of their own volition go to an accident and emergency department to queue for six, seven or eight hours in some cases. They do not do so lightly. In many of these cases people need some sort of reassurance that they, or a child or parent, are not actually dying. If they are examined there will be a certain reassurance. There would also need to be an assurance that any additional treatment required will be received.

My home town of Dingle, located on the west Kerry Peninsula, is in a difficult area. Somebody from Dunquin would have to drive more than 40 miles to the regional hospital in Tralee. That is a long and difficult drive. The GPs in the area recently put forward a plan to the HSE where they would provide 24-hour cover every day of the week. It needed the support of one additional person, which has not been given to the group. There may be good reasons for this, but to a person listening to the discussion, it seemed like a local initiative. I know some of the GPs involved and they would have very good reputations. They would not lightly put forward a proposal they felt would not work, and they felt they could provide a service.

There is no doubt that this would immediately take pressure off the accident and emergency department in Tralee hospital. An elderly neighbour of mine fell recently and had a minor injury to her face. The neighbours rang our house and my wife was one of two neighbours who helped out. There were some cuts and bruises and they cleaned the woman up. Nothing was broken as far as they could see but as it was an elderly woman, they thought they should contact the GP service.

As always seems to be the case when these incidents occur, it was the weekend so they had to contact a back-up service, which arrived two hours later. What I find extraordinary was that the doctor arrived with his bag, examined the woman and indicated that she only needed to have the wound dressed and to have her pain treated with a painkiller. He gave a prescription for this, although it was a Saturday evening out in the countryside. The doctor did not even have a bandage or dressing to treat a minor cut and bruise.

He suggested that the woman should go to the accident and emergency department to have the wound treated. I do not know who is right or wrong in such a matter. It is a nonsense that an hour of this doctor's time was taken to examine this person, indicating that she was okay but the wound needed to be dressed etc. He then indicated that he would give the woman two tablets, but the neighbours argued that he should provide the woman with enough tablets to keep her going over the weekend. He eventually did so.

This is a practical example which drives ordinary people mad. They question how such a case can occur. Who is at fault for this? It is daft to blame the Minister for Health and Children for that, although that is apparently what we are required to do as politicians.