Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

Nobody in Ireland disagrees with the Minister's objective but we would wish for a little more haste in that department than we have seen, a hope, I think, with which the Minister would agree.

I am interested in the "Public Service Reform Plan". In it, the Minister speaks of four teams. The two in which I am interested are the ones that affect the public. Reform dividend and digitalisation are more internal, but delivering improved outcomes for the public and the old hoary chestnut, openness and accountability, are the two I want to talk about.

On delivering improved outcomes, we are still looking at significant numbers waiting for outpatient appointments. As HIQA would confirm, few in the ambulance service across Ireland, while now regionalised, are reaching their point of destination within the appropriate time HIQA has set. The amount of time taken for social welfare appeals is an ongoing issue. While the Government speaks about all of these matters, it needs to set targets for some of them to ensure they are achieved.

Perhaps I will combine it all. On openness, transparency and accountability, going back to that issue of this new patient safety agency I mentioned in the Department of Health which is specified in this document, the Minister spoke well here but he will be aware, not only because it happened in Portlaoise Hospital but as I am sure it has happened in other hospitals as well over recent years, that children died shortly after birth.

There had to be a policy of concealment or covering up at the higher echelons of the HSE for the four years until "Prime Time" highlighted the matter. This concerns the Department of Health. I know that and I am sure the Minister suspects the Department did not know what was going on in the HSE.

While we have wonderful talks about openness and transparency, these concepts do not apply within public organisations if the staff at senior level believe they could have implications for these organisations. Endemic in HSE thinking when it is reviewing a critical incident is the questioning of how openness will affect the organisation rather than the patient or people being served. The Minister can introduce all the freedom of information legislation, ethics, transparency guidelines and whistleblowing legislation he likes – we will not discuss the issue of whistleblowing because I am sure it is being discussed next door – but a problem arises if the thinking I describe is endemic. When the problem is endemic, not among the lower grades but among those earning €100,000, the people on whom we rely to do a good job, one thinks about how people can sit on and conceal information on deaths for four years. Under the Minister's reform package, these are the same staff that he wants to carry out an inquiry. I am really concerned about the part of the Minister's document that states the patient safety agency will be established on an administrative basis initially. We are dealing with the structures of the HSE and the HSE is the culprit in many cases. HIQA is outside the HSE. Why would the Minister put such a body such in the structure that has proved itself to be part of the problem? The HSE is not the solution to some of the problems. Leaving aside the legislation, there is still a culture of protecting the organisation in the first, second and third instance. Perhaps the people come later.