Jerry Cowley (Mayo, Independent)

I am upset about the situation with regard to this Bill. On Committee Stage, I discovered a worthwhile amendment was ruled out of order without any apparent reason as to why this should happen, which was a waste of time.

Amendments Nos. 1 and 2 seek to ensure that the democracy being removed from the health services through the abolition of the health boards is returned and that whatever part of the democratic system the Bill has removed is restored. It is like throwing out the baby with the bath water as there is no point in having a service that does not represent what the people want. People want to have a service they can access. However, we have seen our current service totally destroyed.

It seems we are now taking this road and the Bill seems to be the tool to allow a total dictatorship in our health services, where the Minister will decide what he wants and all opposition will be finished with. We will have to accept the Hanly report, the radiotherapy report and all Department of Health and Children-speak.

I am concerned about this Minister. He is a "Yes" Minister who has no mind of his own. He is taken over by his officials who make all decisions as to what he does or does not do. The zeal with which he took on the smoking ban was welcome. However, to me it smacks of being the good boy and doing what was needed, although I agree it was needed.

We also need a proper funding service but the Minister is not providing that. Instead, he is introducing a new audit system to ensure he can cut back even more. The problem we have had with our health system is its lack of finance and proper capacity. While we all agree reform is necessary, the proposed change is from over representation to gross under representation. This cannot be tolerated. The health strategy talks about equality and fairness. Where is the equality in this? It does not exist. The proposed structure is a complete audit structure to ensure that more money is saved and that we have less money for health services. It can only end in disaster.

The health strategy talks about, as the Minister mentioned on Second Stage, better health for everyone, fair access, responsible and appropriate care delivery and high performance. These amendments are necessary because we do not have fair access, as can be seen from the trolley situation. My locum received a letter yesterday from Mayo General Hospital asking him not to send any more patients to the hospital because there were already 13 patients on trolleys and there was unlikely to be a resolution of the situation. Where are equality, equity and fairness in this? This is health apartheid, which will be further reinforced by the new system.

We all agreed that there were too many agencies and gross duplication in the system. However, what is happening now is a total about change. It is a change to a dictatorship or quango. Yesterday when I asked when the orthopaedic unit would open in Mayo General Hospital, which was supposed to begin on 1 July, I was told it was a matter for the Western Health Board. At least I will get an answer from the board, however, where will such questions be passed from now on? Where will accountability rest?

The Bill proposes a complaints system but that will be of no use. A complaints system for people unhappy with their treatment in the health service has been mooted as an alternative. Previously people could make their complaints to elected representatives. However, the proposed complaints service seems to just provide a session where people will be able to state their gripes on four or six occasions a year. People with a grievance will not get a proper return on any complaint they make. The Minister will end up with people from all sides pressing him.

The proposed system will be another quango which will be as undemocratic as the NRA or any other such body. It is time we ended health apartheid. The confusion over the next six months when all the power of elected representatives goes to CEOs is not good enough. My fear is that in that context we will see full implementation of every wish list held by Department officials. We will see the Hanly report being pushed through and the end of any local service which would give a semblance of a proper health service to which people would have access.

The Minister could have put some money into the primary care strategy this year but he has not done so. Where is the fairness in that or does it show any attempt to improve the situation? The Bill's proposals smack of a Department agenda of centralisation. I cannot understand how the Minister can stand over it. It is regrettable that the Minister of State does not support and will not accept this amendment.

See this speech in context