Colm Burke (Fine Gael) | Oireachtas source

One of the major problems in regard to the provision of health care in this country has been the total lack of planning. A simple example of this can be seen in the figures relating to dialysis services. There are more than 1,800 people receiving dialysis at this time, which equates to some 250,000 appointments in real terms, or 20% of day care procedures in the State. In Norway, by comparison, only 370 people are receiving dialysis, and more than 300 kidney transplants are conducted in that country every year. In Ireland, only 150 of those operations are carried out annually. This situation is a consequence of the lack of planning over the ten years from 2000 to 2010. If people are complaining about the health service, they must look, in the first instance, at the lack of planning.

The health care budget for next year is €5 billion less than it was five years ago, but the services are still being delivered. There are issues that need to be tackled, but the fundamentals are there. In maternity care, for instance, Ireland has among the lowest rates of maternal mortality and perinatal mortality in Europe. That is because we have a dedicated staff delivering a very good service. I support Senator David Norris's comments in this regard. We need to ensure that when there are cutbacks, services are maintained. Reducing the budget should not necessarily result in a reduction in services. On the contrary, it is about achieving better value for money. It is also about setting up proper structures. Another example of a lack of planning is the fact we have more than 2,000 junior doctors on six-month contracts. That particular system has been in place for the past 20 years and is no longer working. As a result, more than 65% of our graduates are leaving the system within 12 months of qualifying from medical college. That problem must be addressed.

According to the Minister, he is dealing with that. He is setting up a structure to ensure long-term, rather than six-month, contracts are offered to junior doctors. These are the issues we are dealing with.

There is a need for a debate on the structures of governance and the six hospital groups we are setting up. We need to look at the system of governance in respect of the area of community care and the system of governance that will be put in place. We have not had a debate on it and it is something we must have in terms of how it will be put in place, monitored and managed.