Brendan Smith: Calls for cross-border GP and hospital collaboration

I welcome our witnesses and compliment Koch on his work over the years. As Michelle said, we had engagement with Tom Daley many times and always very positive engagement. I don't think I'd engage as positively with him now when he's trying to take the Ulster Fine out of Clonus to bring it to a revamped Casement Park. We'd have a slight difference of opinion in regard to those issues, so we would. But just to compliment Tom and all of you who have pushed out the Koch program so successfully, and I have to say Koch was very fortunate in its place of birth in Ballyconnell, so it had a very good start to life in the first place. But anyway, I just noticed that you have quite a disparate number of groups to work with in Northern Ireland. We often think that our health service isn't consolidated enough, but when I see the number of different partners and providers you have to engage with in Northern Ireland, I'm sure it's not that easy. Could I just say, the Minister of Public Expenditure and Reform, Michael McGrath, has indicated to us that he expects to sign off on the Peace Plus program in the not-too-distant future. And, you know, within our own parliamentary party, as Senator Blaney could attest to, we've been urging him to move it along as quickly as possible, and I don't think there are any obstacles foreseen at this present stage to sign off on it. And, you know, whatever we can do to support the programs that you will put in for consideration, we'd be very glad, because all of us, with our experience of the good use you have put relatively small money to in the past, it influences all of our opinions. Could I just say, Rose touched on some skill shortages on the medical side. We also know of the shortages of other clinicians and therapists and nursing shortages as well. Do you have any particular project where you would be training people specifically for the border counties, say, on the basis of collaborating with the Institute of Technology and the General Hospitals? I know my own local hospital in Cabin, Cabin General, we would have student nurses who are doing their nursing degree in Dundalk Institute of Technology. I assume it's the same in Sligo as well. But could there be a specific project to try to train more people, and hopefully those people would take up jobs in the area where they are trained? Because I think it's not easy to attract young clinicians or whatever particular discipline to more remote areas. That's the reality. And go back to the GPs as well. I know that it's generally accepted that the age profile that offered GPs in rural Ireland is high, unfortunately, and it won't be easy to get replacements. And I know that HSE, a number of instances I've dealt with in my own constituency, have struggled to try to get people even to apply for some vacancies at times. Now, we have two different health systems, north and south. Is there any way that consideration should be given to some cross-border GP practices? That you take a remote part of the area that I represent, go into your own area, Damien, in north, east from back, Cabin, along for Manor. There would be small GP practices on both sides of the border. When the practitioner retires, it's extremely difficult to get a new incumbent. I don't know. But it might be worth giving some thought to it, to practices being merged or being amalgamated to some extent. And I appreciate the structural difficulties there would be with two different systems. But we have to think outside the box in regard to trying and ensure that we have reasonable access for people to GP care in rural areas. I think it's extremely important. Could I just say one other thing? And we are living in an era now, and with the particular emphasis by the Taoiseach and the government on the shared island concept, we think we have to see more working on a cross-border basis. We have to see more collaboration. Over the years, say in the past, when the hospital in Oma used to provide ENT services to Cabin Monaghan, now that service is provided by Colerain, a limited amount. But I think there's, I don't know if it's in your remit, we have to have more provision of acute services on the basis of collaboration. When there was a big challenge in regard to replacing the Erdent Hospital in Ennis Gillen and replacing NOMA, I remember at the time the thinking was that with a very substantial Southwest Hospital, that there would be collaboration with Sligo, Cabin Jenner and the new Southwest Hospital. To my knowledge, that has never been achieved what we want. And we have to have a focus on delivering services on a cross-border basis, particular specialties, et cetera. And I think there's, whatever blockages there are, that we have to try to move those out. Because if I have a constituent in Cabin or Monaghan, they want to get the service as quickly as possible. Similarly, I'm sure with our neighbours north of the border as well. So if you could maybe give us some update on, is there any progress being made in that respect? Or what maybe, and I know you are delivering services, but I'm sure you have an input into policy. And I appreciate that up the line, the department, the government level as well. But maybe give us an insight in, is there any thinking going in trying to intensify a cooperation and the delivery of services at general hospitals on either side of the border to service the needs of the people on a cross-border basis in some particular specialties. So again, just very much welcome the work that you do. And as a public representative who has been familiar with that agreement from its inception, I would be very glad to support your work. And I sincerely hope that the programme you put forward to this, especially European Union's programme body, that it meets with approval. Thank you, Oka Heerley. Thank you.