Paudge Connolly (Cavan-Monaghan, Independent)

I welcome the opportunity to speak on the Bill and I support the amendments tabled by Deputies McManus and Cowley. I should declare an interest in that I believe I am the last remaining Oireachtas Member who is still a member of a health board — whatever benefit that may bring.

Reform of the health boards is needed after 33 years but to abolish them entirely is going several steps too far. The Government should have taken a sensible look and if the health boards needed reconfiguring — a popular word in the health service — it should have taken that on board. The make-up of health boards is far from perfect, being comprised as they are of a mix of county councillors and professional representatives. There are 11 professionals and 19 county council representatives as well as a number of ministerial representatives on the North Eastern Health Board. There were some excellent county council representatives but I have to ask whether some councillors were on a gravy train because they were not there to contribute but rather to welcome news from the CEO and be party loyalists. They were seen to have pulled a plum job when, having been elected to the county council, they were appointed to the health board. That is regrettable.

There were professional representatives on the board. Deputy Naughten referred to them as an interest group but while there was an element of that, 11 different professions were represented at health board level whose representatives brought a wealth of experience from each of their individual fields. They may have been self-serving to some extent but many made valuable contributions to health board meetings. I am concerned these county councillors and professionals will be replaced by hand-picked party hacks, appointed to boards of governors to act as "yes" men. The democratic input has been reduced.

When county councillors were on the hustings, the health service was one of the main issues they were asked to address. It was hoped the councillors the people elected would keep their eye on the ball when it came to local health services for which there was a great need in the North Eastern Health Board. I wonder what would have happened if the prototype for the Hanly report had been introduced in that area. The Department appears to have become concerned by the level of objections from all quarters at health board level, particularly the Opposition, and seems to want to do away with that type of democratically elected system, with people voicing objections to proposed changes.

There is now talk of a six month period before further legislation or changes are introduced. This is like letting a fox loose in a chicken house. In that six month period health board executives will be given instructions and the Minister and the Department will demand action. Those executives will not be accountable to anyone but the Minister and we know the changes he wants to drive through. He simply wants to drive the Hanly report through all health board areas. Different Ministers have said the report has been changed but I have not seen a changed version. I am only aware of one version about which I am as concerned as ever.

It is worth remembering that there are many consultants and rural GPs objecting strenuously to the proposed changes which are supposed to modernise services. First, we need an infrastructure to be put in place. The Hanly report states 3,000 extra beds are required but this is never mentioned. We only hear about the negative aspects of the report which affect rural Ireland. People are told accident and emergency services are to be closed down and that they will have to use a centre of excellence which is not available. Where such centres are provided, they simply cannot cope, as extra beds are needed.

I am concerned about property still in health board ownership. In Monaghan the health board owns 100 acres of land and valuable buildings near Monaghan town. Giving power to a chief executive to make decisions about property like this is nothing short of dangerous. We had excellent property committees in the health board in which county councillors came into their own as they could spot both value and someone trying to pull a fast one. For example, when Corbeg Farm in the North Eastern Health Board area was sold, there were certain provisos. Jobs had to be provided and it could not fall into the hands of speculators. It was taken back and resold. That is the kind of valuable work people can do if they are allowed to work through health board committees.

My health board was broken into two sub-committees, a hospitals and a community services committee. At least, members of the hospitals committee went out and visited hospitals, taking on board the concerns of patients and staff. The committees formed excellent parts of the health board and should have been retained. There was also a naming of buildings committee but I question the value of such a committee. Other elements were of equally questionable value to the health board system.

My major concern is that the proposed changes mean there will be nobody to voice concerns about lack of services in hospitals like Monaghan. When Cavan or Our Lady of Lourdes Hospital, Drogheda, go through a rough phase, there will be nobody there to voice an opinion. We cannot go to health board meetings and clap ourselves on the back from start to finish. We are not there to point out the good parts of the service, although we can and do acknowledge them. We are there to be critical and point out the deficiencies but across the country this facility will be lost. This is particularly true of those in rural Ireland. Unless one is fortunate — or unfortunate — enough to live in a city, one will not be able to access services fairly, as outlined in the various health strategies. I am also concerned that there is no longer a democratic input into the health service.

References are always made to how expensive health boards are and people find it hard to distinguish between executive and board members. Board members cost the health service an absolute pittance given the service they deliver. In the North Eastern Health Board they are the guardians of a budget of €500 million. In percentage terms, they account for 0.03% of the total health budget, which represents excellent value for money.

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