Kathleen Lynch (Cork North Central, Labour)

I welcome the opportunity to conclude this debate. There can be few more important issues that this House has to discuss than the reorganisation of our health care. I will start with the two greatest influences on that change this Government is introducing for the benefit of patients and not for any vested interests. First, we have a system that is no longer able to deliver the level of service our citizens need, nor does it represent value for money. No one here would dispute that for a long time our health system, and I heard everyone present say it, has needed to change the way it provides its services to patients. The Government has a clear view on what needs to be done and is setting about doing it.

Second, the financial situation in which we find ourselves exercises and will continue to exercise considerable restraints on the options available to us. However, that will not stop the Government making the changes necessary for better and safer care.

In that context we must remodel our health service, and in particular our acute and emergency provision. It is extraordinary, therefore, that there should be demands to return to a system which has become clinically indefensible and continued provision of which, as my colleague, the Minister for Health, noted last night, is threatening to become untenable, unsustainable and irresponsible. The notion that we should continue on with that system or return to the old system defies logic.

The clinical evidence is clear. We cannot safely continue into the future providing complex care across a large number of facilities at very low volumes. We cannot safely provide complex emergency care in every hospital. Equally, we cannot continue to use our large hospitals for treatments which can and should be provided as close to our patients' communities as possible. We cannot continue to use major emergency resources for injuries and illnesses which can be dealt with in other settings.

The financial evidence is just as clear. We must see a better return in terms of patients outcome for our health spending. We must use new ways of measuring outputs and outcomes from our acute services. This process of using information better to manage our system is already well under way with the advent of the special delivery unit, SDU. The number of beds we have is not an output nor an outcome. The number of staff we have is not an output. What matters is the number of patients treated and despite the reduction in funding, and I am glad to see Deputy McGrath has left the Chamber-----

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