I wish to raise our need to ensure we have enough doctors into the future. A Parliamentary Budget Office report in 2024 on the cost of non-consultant hospital doctors and consultants in a consultant-delivered health service stated we would need more than 9,000 additional hospital doctors within 20 years to meet the demands of our growing and ageing population. Having that number of extra staff in place by 2042 would cost the Exchequer approximately €2.2 billion more per year. To that we can add an additional 1,000 GPs. We need to be adding 500 medics per year after allowing for retirements, etc. As there are several hundred retirements per year, it means approximately 800 doctors per year are needed. Let us work with that figure of 800. What is actually happening in our medical schools is that we have approximately 600 places for Irish or EU medical students and a similar number of places for non-EU students. A significant number of young Irish doctors go abroad, as we all know, and do not return. Statistics are hard to come by but it would seem that approximately 60% go abroad after internship and half of those do not return within ten years. We might expect that at the very best, approximately 400 new doctors per year from undergraduate medicine studies will stay here. That is half our need. We need more Irish people studying medicine and we need more Irish people staying in Ireland after their studies.

Two issues need to be considered. How about making working in Ireland a condition for approximately 50% of Irish or EU college places? If we can reserve places for overseas students, surely we can find ways to reserve places for students who will commit to staying in Ireland for six or eight years. The other issue is the prohibitive cost of entry into postgraduate medicine. Postgraduate entry medics would be less inclined to go abroad. They are the ones who have to face fees of €18,000 per year or €60,000 per year to be invested in their training. That is inequitable. We need to encourage graduate entry medicine. We need a debate about what we are going to do to address this urgent problem of ensuring we have an adequate number of doctors and medical personnel to provide healthcare to our people in the future.