Colm Burke (Fine Gael) | Oireachtas source

I thank the Minister, the Ministers of State and the HSE management for being here today and dealing with the issues that we want to raise. I wish to turn to my questions nos. 34 and 36. Question no. 34 relates to the gynaecological services in Cork and about a time commitment. I always get worried when we talk about setting up committees to review something. One of the requests by the obstetricians and gynaecologists in Cork University Maternity Hospital was that a six-bed day-care unit would be opened. What timescale would be involved for putting that in place?

My second issue relates to the waiting lists. We had meetings in early January, but as I understand it no progress has been made in real terms in dealing with those waiting lists. A total of 42% of all of the waiting lists for the entire country is in Cork University Maternity Hospital. More than 4,000 women are involved. I am concerned that we will be back here in two months time and no progress will have been made on that issue. We might get clarification on deadlines and targets in dealing with that issue.

A further issue relates to the dermatology unit in the South Infirmary Victoria University Hospital. It is treating double the number of patients being treated in the unit in St. Vincent's Hospital in Dublin. I understand that the only space available for secretaries to work in the unit in the hospital in Cork is in under the stairs and patients are waiting on a stairway to go into clinics. The response I got to this, and it is shortest one I have seen in regard to a major unit, both in terms of ENT and that dermatology unit, is to the effect that very little action will be taken regarding the difficulties they are dealing with. Those in the unit have set out quite clear plans for what needs to be dealt with. The staff are working extremely hard and they have even opened on Saturdays to deal with some of the issues to ensure a backlog does not develop. The response I got is not adequate. I wonder if some more progress can be made on it.

I wish to raise a further issue related to question no. 33, and I am intrigued by the answer I got to it. It relates to the breakdown of staff in various departments of the HSE. I am glad to note that the total number of staff has increased quite substantially but I wonder about our priorities in that area. The total number of staff has increased to more than 107,000 from 99,000 in 2014. I am glad to note that the number of care staff has increased by more than 2,142, from 16,000 to more than 18,000, but I am a little concerned that management and administrative staff have increased by 1,647. I am also concerned about how those figures are presented to me today. The annual report of the HSE in 2015 set out that the number of managers had increased from 4,700 to over 5,000 but I am told today that the figure is 1,445 because staff under grade 8 are being re-classified as not being in management. Some massaging of figures is happening and people are not being honest with us. How many staff members, who have moved up to grade 5, grade 6 and grade 7, are going under the radar in terms of the HSE being honest with us about this matter? The number of administrative and management staff increased by 1,647 in two years. The number of public health nurses increased by 39, from 1,460 to 1,499, in the same period. In the past 12 months there has been a decrease in the number of public health nurses.

One imagines we should be prioritising the area to have people out in the community working to keep people out of the hospital services. I am concerned about how we are approaching this.

We are the second highest spender on health in the Organisation for Economic Co-operation and Development, OECD, in real terms. Are we making best use of funds and do we now need to do a detailed review of the management structure in the HSE? An increase of 1,647 administrative staff members in two years is huge and I am not happy. The 2015 annual report stated the number of managers went up by 300. I am getting the response that it is not confirming what management increased by in real terms because the figures are being presented in a different way. That is not fair to us or to anyone in the public. We need the exact figures, presented in the same way that they were for the year ending 31 December 2015. I ask for that to be clarified.

I have asked about forward planning in the HSE for recruitment of medical consultants and medical staff. I thank the staff of the HSE for their work on it. I have received a detailed presentation about doctors in each hospital. That presentation was given to me in January 2014. The last time I asked this, in November, I was told that the information was not available. Surely this should be updated by the HSE every six months for forward planning? It would establish the number of consultants who will retire over the next 12 months to two years in order that the positions can be advertised in advance and not after the consultant has walked out the door. In the response, it shows there are 130 people in either locum positions as consultants or on an agency basis. We should be able to avoid that if we do forward planning. We do not appear to be doing it. If one goes back to the old health boards, 15 or 20 years ago, there was forward planning for consultants retiring. We abandoned that when the HSE was set up. I ask that such a procedure and what we are given today be constantly reviewed every six months in order that management at senior level are aware of where the vacancies are likely to arise and the action that has to be taken.

I have just spoken to someone who came back from a medical conference in the United States last week, having met six registrars with whom the person had dealt and trained in Ireland but who now are working within 100 miles of one another in Canada. We are losing some very good people because we are not doing enough forward planning. I ask that this matter be focused on and for a review every six months in every hospital to make sure we can advertise in advance and not 12 months after the person has gone out the door.

I thank the witnesses for the work presented here today. We need to review why 1,647 additional people entered administration and management in such a short period.