James Reilly (Fine Gael) | Oireachtas source

I would also like to comment on the waiting lists covered by the television programme. It has been an ongoing problem for many years. We want waiting times diminished for patients but it is not and never has been just an issue of resources.

I wish to correct the record for the leader of Sinn Féin. During my tenure as Minister for Health, inpatient waiting lists came down to eight months, despite €2.5 billion less being available. The number of people who had to endure long waits on trolleys, the most acutely ill and seriously sick, reduced by a third. There are still far too many waiting on trolleys and more work has to be done.

The bottom line is that no part of the health service exists in isolation. If we want to cure what is happening in accident and emergency departments and fix our waiting lists, we must fix what is happening in primary care. Unless there is a new GP contract and more emphasis on prevention and early detection, people will continue to wait. As the programme pointed out last night, if people are left on waiting lists they go from being elective cases, that is, having their surgery in a planned way, to emergency cases. All the statistics show that the outcome is not as good for patients and the expense on the State is greater.

I commend the Minister for starting negotiations on a new GP contract but we also have to look at who is doing what within our health service. I have mentioned treating the patient at the lowest level of complexity that is safe, efficient, timely and as near to home as possible. Consultants are doing work that GPs could be doing and GPs are doing work that nurses could be doing. We are all doing work that other paramedics could be doing. All that must change.

I also want to comment on management. It takes six years for a student to become a doctor and approximately four years to become a GP or 12 years to become a specialist. What do we spend on our managers? Many of them are excellent administrators who were promoted into management positions, and who do not get study leave or extra training and are left in place.During our time with the special delivery unit, SDU, we set up a programme to train 30 a year and provide postgraduate training. That programme needs to continue and be amplified. The point has been made that the funds go into the system and that we have the best doctors and nurses in the world. It is management that we need to address. There is no point in Senators giving out about management unless they are prepared to train and support managers during the course of their careers in order that they can do the job we all want to see done.

There is still a need for capital investment. Members have mentioned the emergency department in Galway. The same can be said of the emergency department in Beaumont Hospital. There is a need for more primary care units and day hospitals. All of these things will help to treat patients long before they get to the position where they will need to be in an acute hospital. That is what needs to be done.