Denis Naughten (Longford-Roscommon, Fine Gael)

I welcome the opportunity to speak on these amendments. I support those tabled by Deputies McManus and Cowley. I echo what my colleague, Deputy Olivia Mitchell, said — there is no mention in the legislation of democratic accountability and, in fact, the opposite is the case. It is somewhat hypocritical to be debating the Health (Amendment) Bill 2004 because it should be called the Hanly implementation Bill. That is what is before the House today and once the legislation is passed, the Government and the chief executive officers will have a blank cheque to implement whatever changes they want within the health service. The Minister of State has said that this is the first step in the reform process for the health service but there will be no debate about the reform process and no element of opposition to any of the reform proposals. When the amazing legislation, which we are supposed to see sometime next year, is published all this alleged reform will already have taken place and the Hanly report will have been implemented. That is the reality of what is before us today.

Everyone accepts there is a need for reform within the health service. The penny has only just dropped for the Government, which now realises that, after increasing the health budget from €3 billion to €11 billion, it was only throwing money into a bottomless pit. Everyone accepts the need for health reform and that regionalisation of the non-emergency acute services is the way to go. The issue, however, concerns the emergency acute services which will be regionalised, thus causing deaths. This legislation will facilitate that process.

It is disappointing that on Committee Stage the Minister was not prepared to consider genuine amendments that were being put forward to provide for democratic accountability, which is all we were seeking. The fair and reasonable amendments before the House refer to accountability and democratic scrutiny of executive agencies. Those who provided leadership for the health service in the past, and who had to take difficult decisions at times, were the public representatives on health boards.

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