I will have great pleasure in answering those specific questions. Many consultants are doing excellent work, although many of them feel there has been much "consultant bashing". As with all groups in Irish society there are always some who deserve a good bashing but the vast bulk of people working as consultants in this country do an extraordinary job, going way beyond the hours they are contracted to provide.
To answer the direct question of what is being done now that was not done before, in the past year or 18 months consultants have been coming in on Saturdays and Sundays, although they are not contracted to do so. They are doing ward rounds and discharging patients, as well as examining X-rays and other diagnostics in order to allow diagnoses to be made and patients to be discharged. Those initiatives alone have brought about improvements and saved 70,000 bed days, allowing many more patients to be treated much more quickly.
The Deputy knows about the new stroke care programme that is saving one life per week and preventing three other Irish citizens per week from going into long-term care. He asked about ensuring there are sufficient hospital doctors and I again allude to a previous comment made in the debate on the national paediatric hospital: this is not so much about input but rather outcomes for patients. We can improve outcomes for patients by ensuring consultant specialists are doing the sort of work only they can, with work that can be done by other doctors and nurses done by those doctors and nurses. If health care assistants can do some of the work of nurses, they will do so. With regard to physiotherapy and speech and language therapy, the addition of allied health professionals to the stroke units have made a significant difference.
It is about the right person treating the patient at the right time and with the right cost, and the new arrangements for consultants are a key part of that. They will open the way for many other groups within the health service changing work practices, as they can no longer point to consultants as leaders who do not lead the way. We can significantly improve the care we give in the health service in a far more cost-effective fashion.