Mary Harney (Dublin Mid West, Progressive Democrats)

A number of issues were raised about services. I do not propose to deal with all of them. I assure Senator Prendergast that discussions are ongoing among clinicians in the south east. I was asked when the cancer control programme that is currently being implemented will be concluded. Half of it will be implemented by the end of this year and between 80% and 90% of it will be implemented by the end of next year. The programme, which is led by Professor Keane, is happening at a remarkable pace. Many clinicians were involved in the drawing up of the control programme and are now involved in the implementation of the programme. That is what delivers success. In the past, many proposals were devised by people at management or administration level who then failed to implement them. Clinical involvement, which is the key to success, is central to the new contract of employment for consultants which we have been negotiating for three years.

I know that clinicians, obstetricians and others are involved in discussions about the configuration of services between the different hospitals in the south east, which I visited recently. The Government wants to maintain the hospital infrastructure we have as long as services can be provided on the basis of patient safety. Our system has 4,000 junior doctors and 2,000 senior doctors and consultants. We intend to turn that ratio around the other way. Until we do so, it is not safe to provide some acute services in the absence of the appropriate medical expertise.

Cases such as that of the Mercy University Hospital in Cork often arise in the context of health expenditure. We have made a capital investment of more than €5 million in the hospital. An increase of 54% in staff numbers was sought as soon as we tried to open the new facility, which is not acceptable. That is why the new facility is open between 8 a.m. and 8 p.m. only. Teachers never demand a 50% increase in staff numbers when spanking new schools are provided. Such demands tend to be made in the health system, unfortunately. It is not possible to provide a 50% increase in staff to serve a fantastic state-of-the-art facility that will see an increase in patient activity of just 15%. When new facilities are opened in the health care system, they should help to improve productivity. They should not demand the huge increases in staff that are usually sought.

It has been suggested that cutbacks are being made. The HSE budget for 2008 represents an increase of €1.1 billion on last year's figure. Like any other health authority in any other country, the HSE has to live within the resources made available to it. One has to live within one's health care budget and ensure the health care priorities one has set are implemented, regardless of whether one is operating in a publicly funded system, an insurance funded system, a combination of the two or a privately funded system.

I often hear people saying how awful the HSE is. I refer to people speaking in this House, for example, or the councillors I meet at the regional forums who ask me for meetings. The HSE was established three years ago as a means of addressing the unsatisfactory nature of the health services being provided under a health board regime that had 273 members. All was not perfect then. Many of the inquiries we have had recently relate to events which occurred when the health boards were in place. That is a fact. The establishment of the new HSE organisation three years ago was an undertaking the scale of which had never been seen in Ireland before.

I remind Senator Fitzgerald that a considerable amount of work is being done by Professor Drumm and his team within the organisation's management structure. A new director of human resources will start work in the HSE shortly.