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Go raibh maith agat, a Cheann Comhairle. I first want to thank the Members for their contributions today. Suffice to say that all of the Members who spoke reflected on the fact that we have an absentee Health Minister. Particularly in the hugely important and very human remit that is health, it is nothing short of a disgrace that, when we are debating critical issues like workforce planning, we have no one to act, listen and respond accordingly.
First of all, I want to refer to a number of Members' comments. Fearghal McKinney highlighted the lack of strategic planning in relation to Transforming Your Care, its implementation and its investment, and referred to the clear consensus that we were actually moving towards a plan that was not being implemented.
Michael McGimpsey said that the system does, of course, need a lot of planning and that part of that engagement has to be proper and meaningful engagement with staff. He specifically referred to the regional planning group, which had excluded the staff side, and called for immediate and proper re-engagement with the staff side.
Kieran McCarthy talked about the extreme difficulties that the health service was experiencing, and said that what is happening in our health service is actually a shambles. He stressed the need for staff involvement in workforce planning.
Daithí McKay is surprised that the Department has not carried out an estimate of workforce requirement. That is a critical piece of learning that has come from the review and the need for a common understanding around Transforming your Care. He questioned whether it was a policy direction or simply an ethos. There was no certainty on what the objectives were. He said that, if the Minister does not want to do his job, he should simply step aside.
Rosie McCorley talked about the reality of the health service, which is currently under extreme pressure. Again, there is a lack of clarity on the way forward. All that had been produced over the period of years was the planning framework. She questioned why so much more had not been implemented.
Jo-Anne Dobson referred to the fact that, given the last number of weeks and our in-out Minister, it is no surprise that the former former Health Minister finds it acceptable not to turn up today and respond to the needs of our staff. She also questioned the 50% target for closure of residential homes that was contained in Transforming Your Care and the fact that the report needs to be followed up by actions.
I just want to refer to another few points in terms of the review. As many have stated, the review contained 18 recommendations, and much has been said in relation to GPs. Critical to that, however, is the entire primary care workforce. As my colleague Rosie McCorley said, that means addressing issues around allied health professionals and, indeed, front-line community and district nursing. We heard very specific evidence from the BMA and the college of GPs. They certainly threw into question the Department's commitment to the goal of Transforming Your Care in terms of leadership.
Both organisations — we should not lose sight of this — referred to a crisis in general practice that cannot be ignored. The BMA and the college of GPs highlighted their concern — again, some Members mentioned this — around the number of GPs. The college said:
"we have the lowest number of GPs per head of ... population ... the oldest GP workforce, with 24% of our GPs over the age of 55; and an ageing practice nurse population."
It went on to refer to the:
"three workforce reviews since 2006, with each highlighting the need to increase the number of GPs."
I suggest that those concerns have, quite simply, fallen on deaf ears.
In conclusion, I thank the Committee members and the staff and researchers for their very robust work on the inquiry and recommendations. Three years into Transforming Your Care, the very benchmark of the delivery of TYC, namely our staffing requirement, is not yet resolved. It is simply not good enough that while, over the last three years, 1,620 staff posts were under threat, now, in the last number of months, we have been told that that was simply a working assumption.