Colm Burke (Fine Gael)

I welcome the Minister to the House. I ask the House to bear with me as I have the flu. I hope I will be able to finish my speech.

As a member of the Oireachtas Joint Committee on Health and Children for the past six months I can confirm to the House that very constructive debate has taken place on a number of policy areas and the Minister has attended and briefed the committee on a number of occasions. Many issues face the health care sector and it is important to highlight a report presented to the committee. According to this report, in the period 2000 to 2010, the annual number of patients treated in public hospitals increased strongly, reflecting an increase in population. The key statistics confirm that the number of inpatients and day care patients treated increased by 67% from 788,000 to 1.32 million per year; outpatient attendances increased by 78% from 2 million to 3.5 million per year; and births increased by 36% from 54,789 to 74,729 per year.

The report also states the number of acute hospital beds per 1,000 population in Ireland has decreased since 2000, as has the average length of stay. Given the increased demand for acute hospital care the occupancy rate for acute beds in Ireland is much higher than the OECD average. Also according to the report, the resources available to acute hospitals to treat patients have suffered significant reductions in recent years and this is making it more difficult to treat the increasing number of patients presenting for care.

The total number of doctors working in Ireland is significantly below the OECD average on a population basis. This gives rise to significant pressures in the delivery of primary care and acute hospital services. This is what the Minister inherited along with a shortage of junior doctors and a serious reduction in the number of applicants for new consultant posts.

It was wrong that the HSE encouraged junior doctors to travel to Ireland without first having in place an agreement with the Irish Medical Council as to how they would be registered to practise. I make no apologies for having highlighted this issue in the past four months. I was delighted to see that on the day the Minister, the Irish Medical Council and the HSE appeared before the Oireachtas Joint Committee on Health and Children a memorandum of understanding was signed between the Irish Medical Council and the HSE on how all future recruitment and registration of junior doctors would be managed with clear boundaries agreed between the respective organisations.

The key issue that needs to be tackled is why the vast majority of the more than 500 graduates per year we produce from our universities leave the country within two years of graduation. I am delighted some progress has been made in that all of the parties involved including the HSE, the Irish Medical Council, the medical training organisations and universities together with the consultants and NCHDs are to meet in the coming weeks to look at developing a long-term strategy to deal with this issue. I wish them well in their deliberations and I urge the Minister to do everything possible to ensure we reverse the trend of Irish graduates leaving the country so soon after graduation. On the issue of hospital consultants it appears that we may be facing another crisis. In 2008, 130 consultant advertised posts received 649 applications, or more than five applicants per post. There were only 214 applicants for the 133 posts advertised in the first six months of 2010, or an average of 2.2 applicants per post. In the second half of 2010 the number of applicants for jobs decreased further. In 2003 the national task force on medical staff recommended the establishment of 3,600 hospital consultant posts by 2013 and a reduction in the number of non-consultant hospital doctors. The most recent HSE figures submitted to the Joint Committee on Health and Children on 6 October indicated that the number of consultant posts in the public health system stood at 2,506 in September 2011. Based on the 2003 recommendations there is a deficit of 1,100 consultants compared with the target set for 2013. In the interim the population has increased above the level anticipated in the 2003 report.

I thank the Minister for the work being done in Cork but I will not speak about this issue in depth because I wish to speak about health care reform. A number of targets have been set by this Government to reform the health service, including the introduction of a universal health care package. Despite the many problems which the Minster has faced over the past six months it is important that there are no delays in the implementation of this long-term policy. It is also important that we continue to develop new strategies to provide a more efficient health care service and, in particular, we should put in place a comprehensive policy to deal with computerisation of GP practices and hospitals to make sure that over the long term each sector of the health service can access information without delay. The patient medication card which in Denmark offered savings of over €1.8 billion by 2008 is now being introduced in Germany, which has a population of 82 million. There is no reason we should not set similar goals so that GPs, nurses and hospital doctors can access medical information at the touch of a button, provided they have patients' consent. We can access our bank accounts wherever we travel in the world. We are living in an electronic era and we must move with the times in terms of how we store and access medical information.

Before I conclude I would like to put five questions to the Minister. In June 2011, the HSE agreed to set up a working group to review the current structures for the employment of non-consultant hospital doctors. Did this group meet and has it reported? It was to file a report with Cathal Magee within three months. In view of the difficulties experienced in recruiting junior doctors will the Minister agree to revisit the status of junior doctor posts and work towards increasing the number of training posts? Does he agree that we require a clear target for the recruitment of consultants and will he set out a new five year target?

Given that the majority of nurses have academic qualifications, does he agree there is a need to review the scope of the work they can perform?

There is an urgent need to increase the number of people who are available to provide home help. Many cannot work in this area as they do not have the required experience. Does he agree that the barriers could be tackled by allowing these people to train in local community hospitals under the JobBridge programme? This would increase the number of people available to provide home help and reduce the number of those who require full-time nursing home care.

I thank the Minister for giving up his time to debate these issues in the House.