James Reilly (Dublin North, Fine Gael) | Oireachtas source

The Senator raised an issue about section 16 and the national directors. I have reservations about that and I would be happy to take amendments on Committee Stage. The rationale is as follows. The jobs for national directors can be advertised and then they become eligible to go on the directorate. As this is a temporary arrangement we made a decision to limit it to the wider health family as opposed to outside. We do not want a long process of tendering, appointments and all the rest of it. If the Senator is worried about section 16 we can review that on Committee Stage. It concerns the issue of the director general not giving evidence to the committee on an issue that is being dealt with by the courts. Perhaps the Attorney General has a view on that matter and I will need to revert to the Senator. However, I remind him that it is a temporary measure.

Senator Darragh O'Brien mentioned VHI. The clinical audit is one thing and there is the other audit. We will also now do a deal with VHI and I have informed it of this. I believe it should be doing this on the private side but public patients should not be charged per day any more but per procedure. If the hospital is efficient the procedure will be done efficiently and the patient will be in and out quickly. If it is inefficient then the hospital will lose money. That is the only fair way to do it.

Senator Conway spoke about vested interests. As we challenge and change the status quo the noise will grow to a deafening din - it is getting a bit loud already. We are not afraid of that. We said we would change things and we will do so. As I said on a radio programme, we were elected by the people to do it. They did not say they would like us for the way we did it or that they would like us for having done it, but we will do it.

The value for money audit was mentioned. I have said we are focused on outcomes for patients and not inputs, which formed the main focus of the previous Government. We can measure hospital outcomes in many ways, but we still do not have the measures of outcomes in primary care we need.

Senator Cullinane spoke about rearranging the deckchairs on Titanic - I have dealt with that issue. I have spoken to his obsession with inputs rather than outputs. I have spoken about the consultant talks at the LRC. I thank the consultants' leadership for bringing this to a ballot of their membership. They are leaders in the health service and where they lead others will follow. Senator Crown mentioned nurses and said that there would not be anybody in the theatre to support the consultants - there will be. Nurses are already well used to working different shifts as are others. We will get the efficiency and care citizens need in a much better way. I believe consultants will also have much better job satisfaction.

I am not sure of the accuracy of whether there is an increase in the waiting list for outpatient appointments in Waterford Regional Hospital. The Senator spoke about the announcement of ¤130 million by civil servants - they were not civil servants, but public servants. I appeared on the radio and television the following day to reassure the people that they would not lose their service. Just as increasing inputs does not necessarily improve outcomes, reducing them does not necessarily mean a cut in outcomes for patients. From what the Senator has said I know he agrees with the model of care we are proposing and universal health insurance. If there are real concerns in Waterford Regional Hospital about the new hospital groups we will review it and consult further. The Senator concluded his speech by saying it was not a bad idea but I must do better. I have not heard any better idea from him.