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Chapter 1: What is the main topic discussed in this episode?
The Pat Kenny Show. With Timber Living Log Cabins. Saturday and Sunday from 10am. On Newstalk. Conversation that counts.
taking a good look at all of the news, reviews, opinions and comment in the Sunday papers. And I'm delighted to be joined by my panel this morning. Louise O'Reilly, Sinn Féin TD for Dublin Fingal West. Paul Hosford, Deputy Political Editor with the Irish Examiner. And Pat Rabbit, former Labour Party leader. You're all very welcome to the studio on this Sunday morning.
Chapter 2: What are the main stories covered in the Sunday papers?
I'm going to start with you, Paul, because if we thought that the... Board of the Rotunda or the leadership within the Rotunda capitulating to the Minister was going to draw a line under this issue about public-private maternity care and the battle with the Minister here over the implementation of these public-only contracts for consultants. We were wrong. It's continuing.
Yeah, and it's continuing in a vein, I suppose, that you've seen all week where the minister is almost not necessarily spoiling for a fight, but certainly isn't backing down. The Sunday Times, Jennifer Bray has an interview with Jennifer Cara McNeil. She also has a piece about it.
An internal HSE report that suggests that of 2,837 consultants who have logged their four-week work plan, only 37% say that they'll work in the evenings. Only 11% will say that they'll work on Saturdays and that the minister has laid down a four-week deadline for this to be rectified.
It goes on then, there's a longer interview, excuse me, further into the paper where she says that she had told the Rotunda to end its private maternity care twice and that she had been defiled.
As far back as last summer.
Yeah, and I suppose this is, I suppose, the crux of her, I suppose, her frustration with the Rotunda seems to have been that she had flagged this issue a number of times and that it hadn't been dealt with up until it became, I suppose, a real issue in the last couple of weeks.
I think it's, I mean, you go through the papers, Shane Coleman has a piece in the Business Post about her leadership style or her leadership approach. You've got a piece in the Sunday Independent about kind of where next for this ambitious minister. So Jennifer Carol MacNeill generally on the media and coming out fairly well from this. And I think
Look, I think there's a couple of issues there in terms of how this is discussed. And I think one of them that hasn't really been broached is, look, consultant doctors are not a sympathetic class. They earn a lot of money. And when people go into hospital, their frustration is often that they don't see the consultant enough or they see nurses more than they see consultants enough.
So their perception of their care is often more primary. It's more about who is there often. But I do think that this whole thing risks denigrating the really good work that's done by consultant doctors in our hospitals. Incredibly capable, incredibly intelligent people who work really, really hard. And I think to kind of write them off as either greedy or lazy is,
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Chapter 3: What issues are arising with public-private maternity care?
She said, I'm asking you to go back and look at these rosters again and change these rosters. So is that where she's shifting the blame? Not necessarily saying the consultants don't want to work the weekends. Is she saying the clinical directors within the hospital don't want to have that battle or just haven't got the mindset yet?
to change the traditional approach to the majority of consultants working shift work, which is during the day.
Yeah, but I suppose the other thing is that you do have to roster for when there is demand. And most people are in hospital, you know, busiest during the day, during the week. Clinical directors generally know when they're at their busiest.
Now, obviously, look, if you've ever spent any time in an Irish hospital, you will know that come Friday five o'clock, you're probably not getting discharged until Monday because it's just impossible to get a doctor to discharge, that the levels of cover just aren't there.
And is that why the public don't go into the hospitals as much on Saturday and Sunday, do you think?
I would assume it plays into it. But I think, you know, I think there has to be a kind of a conversation about whether or not there's adequate numbers there, adequate cover. If clinical directors are not rostering people for evenings or weekends, is it because they don't want to work the weekends or is it because they just don't have the bodies to work 24 hours a day?
I want to bring you in, Louise. I can't imagine a Fine Gael Minister for Health from one of the wealthiest constituencies in the entire country fighting the good fight for public health was on your bingo card for 2026.
Yeah, well, you see, this is a kind of a bit of a manufacturer, I think, in some respects in relation to the rotunda, which is fine. But there are consultants working in hospitals the length and breadth of the state and that does need to be looked at. So if you want to see...
sort of where the Fine Gael minister is coming from and where her government priorities lie, you only have to look at the plans for the new children's hospital and there is a very private wing essentially being built, paid for by the taxpayer, but it is a private wing within the hospital. There's no There was no ideological conversion, I don't think, on the part of the minister.
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Chapter 4: How does the Minister's leadership style affect public health?
Yeah. And at a certain point, the public, I think, wants to feel like that budget is being managed or not necessarily shrunk because everyone understands the imperative for it to be spent. It's just about how it's managed, especially if there is a sense. And one of the big worries that you have with something like Slouch Care is that
If you deliver a model of public health where there's always going to be a better alternative privately, then public faith in it will be damaged. And one of the big things with the NHS is that the vast majority of people in Britain up until recently had huge amounts of confidence in it. And that's what sustains it.
When the outsourcing started with the NHS, that's when people started to lose confidence. And when you look, like I was at a meeting on Monday last week in my constituency in Balbriggan, organised by the Balbriggan Community Council, and they're campaigning, as I have been for a long time, for a minor injuries unit to go into Balbriggan. It's a really sensible idea.
It's a population of over 33,000 people serving a catchment area of 63,000. It would make complete sense to put a minor injuries unit there. We don't have a hospital with difficulties getting GPs. We have a health centre, which, you know, is a big enough space to expand. Unfortunately, the way that it was done, it was the HSE only rent part of what is in the health centre
So we don't, you know, the state doesn't own it, but a lot of money went into the health centre, 10 million quid went into it. So you've got to look at where the money is being spent. The budget is big, but if it's not being spent driving care, you know, state funded care, not outsourced, not anything like that.
then we are essentially always going to be coming back to the same place of that constant question of underinvestment. And the money keeps going up, but the services don't match it. You actually need to deliver the services. The HSE needs to deliver the services, not to outsource it. Like we've been told we're getting an X-ray unit. which is very welcome.
That's coming to Balbriggan, absolutely fantastic. But it will be operated by a private entity. It will only operate in certain confined hours and only by a referral from your GP. So it's not a walk-in service. It's not community-based. And the people in my constituency are still going to have to go to Beaumont, where there's queues, or up to Drogheda, where there's also queues.
We're kind of saying something very simple. Community-based care is really important and it also takes the pressure off the hospital. So, you know, that's what Sláinte Care was about. But You have to see where the government are putting the money. They put a lot of money into agency staff, a lot of money into outsourcing. Ultimately, that doesn't benefit the public health system.
And we have an interesting text coming in here from a consultant, which I was expecting before this programme finished this morning.
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Chapter 5: What challenges do consultants face in Irish hospitals?
087 1400 106 is the WhatsApp number. Speaking as a consultant hospital doctor, the main reason that rostering is not evenly spaced across Saturdays and Sundays is because we cannot work clinics and theatre lists without all the support staff, admin, nursing, social work, OT. All those staff are also needed for discharge planning, not just the consultant and the staff that are working.
Weekends are going to be missing for two days during the week, Monday to Friday. The minister is conveniently not addressing that. I want to go to another story that's on the front page of the Sunday Times this morning. If you're at home and you have your newspaper in front of you, maybe you've already seen it.
John Mooney has been writing about how Angarda Siakana has established a new national security service to tackle threats ranging from espionage and cyber attacks to political extremism and terrorism. And joins me on the line now. John, this is...
Look, it's not an entirely new intelligence agency, but rather a reorganisation and expansion of capabilities that already exist within An Garda Siocana. Can you tell me what its purpose is going to be and whether this new service will have any powers that the Garda do not already possess?
So there's legislation, I suppose I'll deal with one question at a time. So the guards have, I suppose, taken certain actions now because there's a changing security situation right across Europe, but also within this country. I think they've been very aware of the fact that many people are conscious of problems with foreign states or hostile states operating here for malign purposes.
But in, I suppose, the past year, the more this is highlighted, you'd see you've seen certain actors, I suppose, in fringe elements of the media and also on social media. dismissing this kind of thing while it's become a significant problem.
So I think they were keen to come out of the shadows and state exactly what they were doing to address these issues and confront them in this new kind of policing world that they find themselves operating in. So the guards have always had a capability of dealing with counterintelligence and protecting the national security.
But what they are doing now at the moment is segregating that and setting up a dedicated security service within their own organisation to deal with that. Because traditionally what you had was crime and security being traditionally mixed together. So they're segregating that. I think there's lots of different reasons for that.
I think they're bringing in additional capacity and capabilities and specialist services to deal with these problems, which are constantly evolving. And I think you'll see sort of a further separation of criminal policing as opposed to security policing in the coming years.
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Chapter 6: Why is the public's perception of hospital care important?
The new security measures that are being advocated that are the subject of debate, not our economic capacity to rapidly ramp up our provision.
OK, because he does point out in this article, Paul Cleary, who's leading up this new deputy commissioner, he talks about taking the work out of the shadows and he talks about greater transparency so the public can see what it is within reason that the security service does.
But to that point that Pat makes, Louise, is the biggest problem here that we are actually still woefully inadequately funding these departments. Do we need to look at increasing our defence spending?
Well, I think, you know, obviously this is an initiative of Vanguardia Siocana, so it's separate to defence. But I think the issue around defence, when I think about it, I think about the people that I know and the men and women in my own area who are members of the defence forces. They find themselves in a situation where the numbers are decreasing. because it's not an attractive place to work.
So I think there's a whole range of things that, you know, from this, you know, security intervention right through to the terms and conditions of the people who are literally on the front line.
So I think there's a whole conversation that needs to be had in relation to investment, investment in people, investment in infrastructure, investment in the technology, because clearly when we have, you know, when we face those kinds of technological threats, then we need to be equal and adequate to the task of understanding them and defending against them.
But when I hear things like An Garda Síochána are going to establish a digital fortress, that sounds good. However, the people that I'm representing, they just want to see a guard in their local area. So there is that as well. And it's not... It's not all high-level stuff. The job of Angarda Síochána is very visible to be in the community.
And when you talk to people, if you ask them, do they want a digital fortress? They might say yes, they might say no. If you ask them, do you want to see more guards on the streets? They will 100% always say yes.
Yeah, but we need to, I suppose, do all of these things in parallel, don't we, Paul?
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