Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

What we need are targets that are based on patient outcomes. We need to do proper a clinical audit as to what happens to the patient, not when the vehicle arrives, and that is now being done. Dublin fire brigade already does a clinical audit and for the first time the national ambulance service will start doing a clinical audit this year and that will give us patient relevant information, rather than just times. There are three reports, one is published and two are pending, and when we have those we will put an action plan in place.

I think it was Senator MacSharry who pointed out that there are 90,000 fewer medical cards in 2014 and there will be fewer again this year, about 60,000 fewer. That is true. The economy is improving. More people are getting back to work and at least for some people incomes are rising and therefore fewer people are entitled to medical cards on a means test. However, the number of discretionary medical cards - those who get them on, for want of a better word, medical or compassionate grounds - is increasing. It has increased from 50,000 at the start of 2014 to 75,000 now and that reflects some of the changes that were announced by the Minister of State, Deputy Lynch and I a few months ago. It is still a work in progress and it is by no means perfect, but the fact that there are 25,000 more discretionary medical cards tells a story. The more I look at this issue when it comes to medical cards, the more I am convinced that universal health care is the only solution. Once we have a means test there will always be somebody who earns a few euro more than the qualifying threshold and somebody who does not fit the clinical criteria. That is where we need to go and that is still very much the vision.

Regarding nurses, there has been some concern today about coverage in the news about there being 1,000 nurses who may retire. It has been difficult for a number of years to retain nurses and fill nursing posts. Some 36,000 nurses work for the HSE and the voluntary hospitals funded by the HSE, so 1,000 represents 3% of the nursing work force. A 3% turnover in a workforce in any given year is not enormous.