Sean Barrett (Independent)

I welcome the Minister. We said everything on this matter on the last day and the warmth of the support for the Minister in this measure is reflected by everyone. As Senator Burke said, the competition aspect of what we did previously must have been open to challenge. This measure will allow young, enthusiastic new doctors to practise and it may be just what the health service needs. To achieve universal support for the measures should embolden the Minister on his reform agenda. We look forward to hearing more about that and supporting him. If we get the new enthusiastic GP service, it affords the opportunity to move people to GPs from outpatient departments, which costs several multiples of a GP visit even though they are financed differently. Over 90% of outpatients are not admitted to hospital and I wonder if they could have gone to a GP. The Minister referred to group practice GPs, where specialties can be split between the practitioners.

Professor Drumm's book suggests pressure to equip 3,000 beds should be resisted until we get reforms. Do we really need them and is there too much hospitalisation, which costs thousands of euro every night? We know this from the hotel costs from health insurance bills. There is a real chance to reconfigure the health service, starting today, with less hospitalisation, fewer outpatients and more being done in GP surgeries. Senator MacSharry mentioned the data on de-skilling GPs, to which the Minister referred. If GPs operate too close to a major hospital, they may become de-skilled by referring many people to that hospital. Perhaps this should be considered.

I commend the Minister on the booklet Health in Ireland: Key Trends 2011, which he circulated among us. It contains facts that get lost in the current debate. While there are now cutbacks because of the financial difficulties, the number of medical and dental staff has increased by 20.2% in the past decade. There are 44% more consultants in the system and 48% more GP agreements. Page 57 of the booklet shows that, with expenditure of 11.4% of gross national income, Ireland does not underspend on the health service. Our expenditure in this regard is nearly two percentage points greater than that of the United Kingdom. The idea that the health service has been starved by evil people in the Departments of Finance or Health is incorrect. We must circulate the facts. The number of staff has been doubled since the 1980s, from 55,000 to 110,000, and we have invested resources. The economic recession affords the Minister the opportunity to carry out reforms that should probably have been carried out already. We have certainly fired a vast amount of money at the health service, and reforms such as the one in question are most welcome.

I am concerned about hospital stays and the Milliman index result that Ireland's average stay is over ten days. Best international practice would require a reduction to 3.7 days. As the Minister stated on the last occasion, there is intervention with the VHI to address the problem. Keeping people in hospital for too long, at a cost of €1,000 per night, is not only blocking beds but also costing the economy vast sums.

I join all the other Senators in stating reforms such as this one contribute to making the professions more competitive and effective as the country attempts to trade itself out of its economic difficulties. The Minister's colleague introduced legislation of a similar kind to open up the veterinary field yesterday. He received the same ready reception in supporting the House. I thank the Minister for Health. The kinds of reforms on which he is working are very important because we have spent considerable money in this area, although the public believes we have not. Sometimes it is necessary to put the facts before the public because the producers are pretty effective at lobbying. Sometimes what they say is not supported by the facts, including the fact that a substantial number of extra staff were recruited over the past decade. The data are in Health in Ireland: Key Trends 2011. Those recruited have not all been bureaucrats as many others have been recruited also, even though there may be too many bureaucrats. The system needs to be streamlined.

I would like to have competitive health insurance extracting costs from the hospital system. As the model is refocused, perhaps hospitals should be allowed to compete against other hospitals, rather than operate through the large health boards we built in the past. This might improve the overall efficiency of the system. This measure is a very good start and I support the Minister.