 Mr. Peter O'Rourke, orthopedic surgeon at Letterkenny University Hospital. Good morning to you. Good morning Greg. Nice to speak to you as always. Right, now to the lay person. This is me as someone not involved in politics or in medicine. It would, to all intents and purposes, seem that Leeov Radkar, and now his health minister, is blaming pressures on hospitals over Christmas and into the new year on staff, on consultants, on nurses taking extended annual leave. In your opinion, your knowledge, is that the case? No, it's not. It's the case of looking for someone to scapegoat. Mary Harney was very good at that in the past. She always used to pick on the consultants and blame us for everything. On this occasion, they're blaming everybody who works in the hospital, which is not the case. The reality of the situation is that on days like Christmas Day, New Year's Day, Boxing Day, Stevens Day, the same staffing levels are on as would be on any weekend. It isn't the case of masses of hospital staff are taking time off, and there aren't as the Taoiseach suggested beds being closed because there's no staff available. 25 years ago, hospitals used to close wards at Christmas because there was no need for them. Now there's a need for extra beds and there's no suggestion that I know of any hospital who do. The only thing I can see different from the rest of the year is that, you know, public holidays are maybe more tightly grouped over Christmas. That probably means there may be less staff about. Well, again, it's the same level of staffing as any Saturday or Sunday. In reality, Christmas Day is probably one of the quieter days in the hospital. The sort of things you, as an orthopedic surgeon, we'd see is people slicing themselves with the carving knife on the turkey after a few glasses of wine. But by and large, Christmas Day is a relatively quiet day. They usually get a massive influx of patients on the 27th when everybody has sort of finished their festivities and the families are no longer under pressure for social activities that then it's when an awful lot of people present to the hospital. The only potential delays are for investigations, but I mean, Christmas Eve, I mean, I frequently run clinics on Christmas Eve. If my clinic day falls on, say, the 25th to the 26th, quite often we'd run a clinic before Christmas or on the 27th just to make sure the patients weren't waiting too long and people didn't fall between the cracks. So people do run extra clinics around the time to minimize the effects on patients. We try to get as many patients at home as Christmas and we don't keep people in unnecessarily over Christmas. So I think it's more attempt to scapegoat a problem because I suspect what they're really saying is that there's going to be a crisis at Christmas and there's nothing we can do about it now. So let's look for somebody to blame in advance. Which is quite worrying. They weren't off the cuff remarks. He made them and then he traveled to Finland and he doubled down on them. And I think he even went as far as to say that if he had it within his gift to sort of ban or restrict annual leave over that period, he would. I mean, that's quite remarkable from someone, particularly with a medical background. It is. And it's rather foolish because all he's doing is aggravating people and suggesting, I mean, it's a blame game. And for the last six or eight years, there's been a crisis every winter and the government have done nothing to resolve the problem. Now, the only solution to the problem is extra beds. Now, even in Lefford, we're told we're getting extra beds. But by the time staff are employed to actually service those beds, it'll take months and it's going to be after the winter crisis before any of these things would actually be available or any benefit to hospitals. What also surprised me is that he made the comments before, I mean, I would have thought we're in winter. Obviously, we're not into the depth of it, where we might see an increase in admissions or maybe we are. But I mean, the HSC itself hasn't even as far as I'm aware come up with or funded sort of the extra resources, the winter plan to try and deal with any increase. It's remarkable that you have an executive that heading towards mid-November hasn't that in place and then you have the head of it through Simon Harris turning on doctors and nurses. Well, the reality is there isn't a solution. They don't have a solution. The only solution is to put a lot of extra beds and make them available. But they cannot one, physically open them because in a lot of cases, there isn't a physical bed. And two, they cannot get staff to actually service the beds. There aren't the nurses out there. So they are doomed to failure as they have been every year. And this is just a case of looking for a scapegoat. There is no plan that will resolve the problem. We will have a winter crisis. No matter what efforts or what spin is put on it, it is unavoidable. The only solution they have is to virtually cancel any planned elective surgery in the period. And that is the only potential avenue they have to try and minimize the crisis. And then at the end of that period, there will be lots in the papers about how waiting lists have gone up and the waiting lists have gone up because people can't do the work. It also sort of controls the narrative to some extent and would give the impression that this is a winter problem. Yet we've seen in summer months and coming out of the summer, record levels of overcrowding, not only at Latter-Kinney University Hospital, but other hospitals around the country. Yes, we'll see a peak over Christmas. But these comments would give you the impression that it is a Christmas new year problem, but we know it's not. We know it's all year round now. Well, for years, we had politicians telling us we had more beds available in Ireland than there are in various OECD countries and in everywhere in Europe, and that we should be treating patients as A-cases and its primary care to treat patients, not hospitals. And they've told us that for years, and we kept telling them they were wrong, that we needed the beds, and it's come home to roost. I don't want to come across as if I'm coming down on one side of this, but I speak to the nurses and you do, of course, all the time. And you know, the pin of their collar, they're under pressure. The working all the hours God sends, they're taking their stresses home with them. Morale obviously is going to be affected by this. When you've got your ultimate boss through the health minister and you've got the leader of the country effectively saying that you're skiving off at Christmas time and in the new year, I can only imagine what that would do for Morale and what that would do for these people that work in such difficult situations because of a lack of staff. Oh, it certainly doesn't help the situation. And I suspect they're heading for a bit of industrial turmoil with the nurses who have been badly treated for years. And I suspect that, I'd say in the next few months, there'll be a lot of industrial issues regarding that as well. But it's just, it's a perennial problem. And unfortunately, unless an awful lot of beds are put into the system, it won't improve. But one of the other difficulties they have as well is when hospital waiting lists go up, they divert money into the NTPF, which puts it into private hospitals. Private hospitals are booming in Ireland. And unfortunately, private hospitals, in order to service their needs, recruit a lot of nurses which are recruited out of the public service where they're trained, which means we can't get staff. And if you're working in a private hospital, nine to five Monday to Friday, it's far preferable for a lot of people than working nights, weekends, etc., because private hospitals are working a different basis to the public system. Given what you know, given the T-shox comments and the Minister for Health's comments, have you got faith in the minister? Have you got confidence in the Minister for Health? Yes, I think he has the potential to be one of our better ministers. But the problem is, I always wonder, if there is a crisis after crisis after crisis, is it the people who are advising him that are the problem, perhaps they should change rather than the minister changing? I mean, ministers, to be fair, are doing their utmost to improve the situation. But unfortunately, they are reliant on advisers and I have to suggest that maybe the advice they're getting is wrong, and that may be part of the problem. And just finally on that part of it then, so, in your opinion and in your knowledge, is there any sort of extra, extra annual leave taken by nurses, by consultants, by doctors over the Christmas period in the first two weeks of January compared to other times of the year? I would, well, I'm quite sure a lot of people do take holidays then because their children are off, so if you have young children, you can take a holiday. But no different to Easter or no different? No different to any other time of the year. And the other thing is that the mere fact that someone's on holidays does not mean their service stops. The people who are there are committed to running the service. So if you have, you know, four, say, surgeons and one of them is away, the other three surgeons are doing the four surgeons' work. Nothing is delayed and nothing is cancelled because of that. And in surgical point of view, to be honest, I take a lot of time off in January myself, but there is someone who slots in and fills my role. We have a locum who comes and the reason I go away a lot in January is because I'm not allowed to operate. So I prefer to take time off then and not take off time when I'm in a position to operate because I have an operating list, I don't want to waste it. So I never lose an operating list by going on holidays. And people are entitled to holidays. I mean, that they are everyone in every industry. And look, no one takes more holidays than politicians if you look at how often the doll sits. And you made a very good point there. Are you expecting doctors and nurses to give up time with their family over Christmas when no one else does? And a lot of don't, a lot do sort of put their shoulders to the wheel and this is the thanks they're getting. I mean, even people who would come in when they're not on call on Christmas Day just to check up with their patients, because especially at a time like this when Christmas Day falls on a Tuesday. So effectively, it's almost a five-day block. People who aren't on call and have no roster obligation to come into hospital come in to check up on the patients to make sure everything's smooth or to see if patients are fit enough to go home. So, I mean, we do run the hospitals as efficiently as we can. But the problem is we don't have enough resources and the lack of resources sometimes causes inefficiencies but it's not because of lack of a wheel or input from the doctor.