Bernard Durkan (Kildare North, Fine Gael)
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Why is the system not working smoothly? There was a reference made following an investigation recently about the chain of command. How is the chain of command operating? I do not think it is operating at all and I do not think it has for many years, certainly since the health boards and regionalisation disappeared. There appears to be an amorphous mass somewhere in the centre, a hazy, foggy, no-go area full of pitfalls and traps and all sorts of things where nobody seems to go. The Minister of State is hinting that everybody is afraid of something. What are they afraid of? There would be nothing to be afraid of if the system was working properly. If everything is done in accordance with the rules, fine, although accidents will still happen.

I mentioned the various causes of claims. The size and severity of the claims is one thing, but the reason for the claims is another. I have dealt with a couple of cases recently where there was a clear indication to me that some things that should have been done were not done and patients suffered as a result. There was a reluctance to admit it, even though full disclosure is supposed to be in operation. What does one do? I would have thought that, in such a situation, management would make a tentative offer without prejudice, or whatever the case may be. None of those things happened. Cases go to court and eventually, on the steps of the court, somebody decides to settle. That is not the way to do business.