Joe O'Reilly (Fine Gael)

I welcome the Minister to the House. Today's announcement that ten acute beds will be lost to Monaghan hospital in my constituency forms a sad backdrop to tonight's debate. Peadar McMahon from the Monaghan Hospital Alliance, who is well known to the Minister, is outside the gates protesting on that issue.

Current health strategy in this country is predicated on developing a GP-led primary health care service on a nationwide basis. I am in favour of such an approach. Primary care at local level is the key to the delivery of health services. It can contribute to a freeing up of hospital places and the delivery of a better, more patient friendly service. I am proud that one of the leading national examples of primary health care is situated in Virginia, County Cavan, which is in my constituency.

The provision of primary health care centres is wonderful in theory, if only it could be put into practice. However, we cannot deliver proper primary health care in this country without 500 additional doctors and 2,000 additional nurses over the next ten years. At present we have one of the lowest ratios of general practitioner to population in the OECD, at 2.8 per 1,000. It is nonsense to talk about the delivery of a primary health care service when we have a dearth of GPs. I ask the Minister to address that issue. Rather than freezing recruitment we should be engaging in a proactive campaign to entice the requisite numbers of GPs into the system. We must provide the necessary college places, training and attractive terms and conditions. We simply do not have enough GPs or nurses to deliver proper primary care.

In the psychiatric area, which is a critical one, we need 20 staff members for every 50,000 people. Such staff are not in place currently. In order to deliver front-line, community based psychiatric services we need an increase in medical personnel and a greater investment in the area. If we must make cuts, as Senator Coffey said earlier, we should look to bureaucracy, administration and other areas of waste, but not to front-line staff.

The dental services are suffering as a result of the cutbacks. Last year, in the area that I represent, including Bailieboro and east Cavan, the primary school children did not undergo the dental screening process that is normally done in first and sixth class. The embargo on recruitment will prevent the appointment of the dentists required to alleviate that situation. There is an inadequate complement of dentists to deliver the services that are required in the north east region.

There is clearly a crisis in the area of maternity services. The services have not been adapted in terms of medical personnel or space to deal with the rise in the number of births. This was recently referred to by no less objective a source than Dr. Michael Geary, Master of the Rotunda Hospital.

In the worst of times in Ireland, in the bad old days when we were less prosperous, we at least had a quick response to cancer patients. We talked about cancer with awe and fear. Now it is possible that a patient could have to wait six months for radiotherapy treatment. It is unthinkable.

During the last general election campaign Fine Gael pointed out that 1,000 health service jobs would be cut by the Government, which was denied by Fianna Fáil and the Progressive Democrats. In fact, they countered by saying that 4,800 new jobs would be created in the health service. What do we have now? We have a freeze on recruitment across the entire service. It was a travesty of truth to deny the proposition put forward by Fine Gael that 1,000 jobs were at risk.

We are making cuts in the wrong places and are under-investing. We need people at the coal face in order to deliver a proper medical service. At a time of great prosperity, when we have reached a level of sophistication and wealth never seen previously, it is a great indictment of our society that we are having this debate tonight. I urge the Minister to lift the embargo on the recruitment of coal face staff, whose numbers must be increased.