Sean Barrett (Independent) | Oireachtas source

I would like to hear the Minister also. I welcome the Minister and reiterate our support for what he is doing on tobacco. I note that under a previous Leader of his party, he would be expelled for voting for his own Bill on the branding of tobacco. I believe he is against plain packaging. We will be on the Minister's side on that issue.

We are moving in the right direction in the health service but there are problems. Do we have an edifice complex? We have put in €5 billion worth of capital expenditure over ten years and yet the number of acute hospital beds decreased in that period by 1.9%. Are people staying in hospitals too long? That is certainly a theme in the Milliman report which shows as follows: medical inpatient admissions, in hospitals paid for by VHI, average 10.6 days, well managed 3.7 days, almost 2.9 times as long; and surgical implant admissions, paid by VHI, average 7.5 days, well managed 3.7 days, two and three times as long. Does that mean there are two and three times as many hospital beds?

Are we deskilling general practitioners? We have had forums on the issue previously, one of which was chaired by the ubiquitous Mr. Fintan O'Toole when neither of us was in the House at the time. Do general practitioners near hospitals become clerical people just referring people to consultants and writing references and medical certificates for people who are not really sick.

I am concerned, as is Senator John Crown, about the bureaucracy problem. The health service statistics record that we have 8,142 medical and dental staff but 16,000 administrators. The current Book of Estimates shows those administrators do not come cheaply at about €71,000 per year and the pay has increased by 10%, a combination of a pay increase in the pay bill for the Department Health and a reduction in the number of staff. I would be concerned about the layers of administration and would share Senator Crown's concerns in that regard.

We need a value for money culture. I am concerned that so few people who attend accident and emergency units are admitted. I wonder what kind of accident it was and what kind of an emergency it was and why general practitioners could not have administered to the victims. I am concerned there are so few new general practitioners when we deregulated access to general medical service. The Minister of State at the Department of Health, Deputy Alex White, told us recently that only about 100 new general practitioners have joined and we still have other general practitioners earning €700,000 per year on that scheme. I applaud the Minister's radicalism and will not intrude on his time to reply. There is much to be done. We need competing hospital trusts, as Senator John Crown said, so as to be able to get value for money. Too much bureaucracy would stop that. I deplore as he does the gagging culture in the UK where people are not allowed to speak in public when they want a service, which is a public service, to be improved.